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General NPI Number Information
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NPI Number | 1700116951
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Entity Type | Individual
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Provider Name | MICHELLE LEE PORTER R.PH.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 11951 N 1ST AVE
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City | ORO VALLEY
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State | AZ
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Zip | 85737-8593
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Country | US
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Telephone | 520-531-8964
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Fax | 520-531-9062
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Provider Business Mailing Address
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Address Line | 11951 N 1ST AVE
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City | ORO VALLEY
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State | AZ
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Zip | 85737-8593
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Country | US
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Telephone | 520-531-8964
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Fax | 520-531-9062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13931
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302029873
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13118
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License Number State | AZ
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