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General NPI Number Information
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NPI Number | 1891552758
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Entity Type | Individual
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Provider Name | LAURA AGNES PORTER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 17053 S OUTER RD. 1ST FLOOR
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City | BELTON
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State | MO
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Zip | 64012-2185
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Country | US
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Telephone | 816-974-5050
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Fax | 816-388-9369
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Provider Business Mailing Address
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Address Line | PO BOX 749495
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City | ATLANTA
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State | GA
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Zip | 30374-9495
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Country | US
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Telephone | 855-963-2100
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Fax | 813-321-1296
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-82966-101
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2024008620
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License Number State | MO
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