Provider Demographics
NPI:1881231934
Name:PORTER, JANET RENE (APRN, PMHNP-BC, DNP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:RENE
Last Name:PORTER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12302 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1434
Mailing Address - Country:US
Mailing Address - Phone:573-289-0816
Mailing Address - Fax:
Practice Address - Street 1:14200 W 134TH PL STE 400
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6140
Practice Address - Country:US
Practice Address - Phone:913-738-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019043670363LP0808X
KS53-78966-022363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health