Most Relevant Information
Provider Data
| NPI Number: | 1003297664 |
| Provider Name: | KIMBERLY PORTER CNM, WHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LW0102X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704246721 |
Most Important Dates
| Enumeration Date: | 06/09/2015 |
| Last Updated: | 11/29/2017 |
Provider Practice Location
1005 W GREEN ST STE 301
HASTINGS
MI
490581729
Practice Location Phone/Fax
| Phone: | 2699458080 |
| Fax: |
Provider Mailing Location
100 MICHIGAN ST NE
MC 845
GRAND RAPIDS
MI
495032560
Provider Mailing Phone/Fax
| Phone: | 6162582386 |
| Fax: |