MEDICARE: VALERIE PORTER RN BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach
2	171400000X	Health & Wellness Coach		KS

General Provider Information

NPI Number	:	1346080900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE PORTER RN BSN

Provider Business Mailing Address
First Line	:	901 S KANSAS AVE
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66612-1210
Country	:	US
Telephone Number	:	785-783-4080
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 S KANSAS AVE
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66612-1210
Country	:	US
Telephone Number	:	785-783-4080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2024
Last Update Date	:	05/30/2024

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