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NPI Code Detail

MEDICARE: TREANA PORTER APRN

MEDICARE: TREANA PORTER 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 Practitioner71008601AIN
2363L00000XNurse Practitioner71008601AIN

General Provider Information

NPI Number : 1952879603
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREANA PORTER APRN
Provider Business Mailing Address
First Line : 1545 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2306
Country : US
Telephone Number : 317-923-1491
Fax Number :
Provider Business Practice Location Address
First Line : 1545 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2306
Country : US
Telephone Number : 317-923-1491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2018
Last Update Date : 10/14/2025

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