Provider Demographics
NPI:1124401419
Name:PORTER, ALLISON LINSEY (LDN, RDN)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:LINSEY
Last Name:PORTER
Suffix:
Gender:F
Credentials:LDN, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6431
Mailing Address - Country:US
Mailing Address - Phone:910-341-0145
Mailing Address - Fax:910-202-9966
Practice Address - Street 1:4005 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6816
Practice Address - Country:US
Practice Address - Phone:910-790-9949
Practice Address - Fax:910-202-9966
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004550133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered