Provider Demographics
NPI:1912966284
Name:PORTO, HEATHER ANDREWS (CNM)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANDREWS
Last Name:PORTO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:ANDREWS
Other - Last Name:LENTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:4660 KENMORE AVE
Mailing Address - Street 2:SUITE 902
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1313
Mailing Address - Country:US
Mailing Address - Phone:703-370-4300
Mailing Address - Fax:703-370-0044
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 902
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-370-4300
Practice Address - Fax:703-370-0044
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9239203176B00000X
VA0024167180176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife