Provider Demographics
NPI:1700295524
Name:PORTER, KERSTIN (NP, HP)
Entity Type:Individual
Prefix:
First Name:KERSTIN
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:NP, HP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 LIMESTONE COUNTY ROAD 170
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642
Mailing Address - Country:US
Mailing Address - Phone:469-364-2448
Mailing Address - Fax:
Practice Address - Street 1:403 LIMESTONE COUNTY ROAD 170
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642
Practice Address - Country:US
Practice Address - Phone:469-364-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Yes374J00000XNursing Service Related ProvidersDoula
Yes175F00000XOther Service ProvidersNaturopath