Provider Demographics
NPI:1295566560
Name:PORTE, EMILY (CRNP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PORTE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 IRON GATE RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3359
Mailing Address - Country:US
Mailing Address - Phone:410-588-7415
Mailing Address - Fax:
Practice Address - Street 1:604 HOAGIE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1884
Practice Address - Country:US
Practice Address - Phone:410-893-4844
Practice Address - Fax:410-893-4927
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR237334363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics