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NPI Code Detail

MEDICARE: MRS. KIMBERLY STOREY PORTER FNP, APRN

MEDICARE: MRS. KIMBERLY STOREY PORTER FNP, APRN
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
1363LF0000XFamily Nurse PractitionerARNP 9306676FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619250529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY STOREY PORTER FNP, APRN
Provider Business Mailing Address
First Line : 1819 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-3356
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 1819 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-3356
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2011
Last Update Date : 07/18/2022

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