Provider Demographics
NPI:1588807069
Name:PORTH, LINDSEY RACHELLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RACHELLE
Last Name:PORTH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5555 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-2460
Mailing Address - Country:US
Mailing Address - Phone:772-206-2262
Mailing Address - Fax:888-498-4434
Practice Address - Street 1:2770 INDIAN RIVER BLVD STE 400-S
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4299
Practice Address - Country:US
Practice Address - Phone:772-206-2262
Practice Address - Fax:888-498-4434
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9238673363LF0000X
FLAPRN9238673207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 9238673OtherARNP