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General NPI Number Information
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NPI Number | 1881267474
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Entity Type | Individual
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Provider Name | RACHAEL PORTER
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 25 BIRCH ST STE 204
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City | MILFORD
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State | MA
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Zip | 01757-3585
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Country | US
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Telephone | 508-568-9335
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Fax |
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Provider Business Mailing Address
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Address Line | 4361 E EDISON ST
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City | TUCSON
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State | AZ
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Zip | 85712-3238
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Country | US
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Telephone | 508-498-0451
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 266688
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2380610
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN160001
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License Number State | AZ
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