Provider Demographics
NPI:1922624014
Name:PORTER, EMILY KAYE (MS, RDN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KAYE
Last Name:PORTER
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:LEAHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3450 N COMMERCE ST APT 706
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1548
Mailing Address - Country:US
Mailing Address - Phone:580-221-1920
Mailing Address - Fax:
Practice Address - Street 1:2401 N COMMERCE ST STE C
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1311
Practice Address - Country:US
Practice Address - Phone:580-226-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered