Provider Demographics
NPI:1336614957
Name:PORTER, MONICA N (FNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:N
Last Name:PORTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 MEDICAL CENTER DRIVE
Mailing Address - Street 2:MARSHALL KIDNEY CARE & HYPERTENSION CENTER
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702
Mailing Address - Country:US
Mailing Address - Phone:304-526-2532
Mailing Address - Fax:
Practice Address - Street 1:1690 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701
Practice Address - Country:US
Practice Address - Phone:304-526-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN47741NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily