GRETCHEN EVANNE PORTER RN CNP LAC NPI 1558372953

NPI Information

NPI: 1558372953
Provider Name: GRETCHEN EVANNE PORTER, RN, CNP, LAC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
5208 BLOOMINGTON AVE
MINNEAPOLIS, MN
ZIP 55417
Phone: (612) 916-0774
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Gretchen Evanne Porter, RN, CNP, LAC is an adult health nurse practitioner in Minneapolis, MN. Gretchen Evanne Porter, RN, CNP, LAC NPI is 1558372953. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5208 BLOOMINGTON AVE
MINNEAPOLIS, MN
ZIP 55417-820
Phone: (612) 916-0774

The enumeration date for this NPI number is 8/10/2006 and was last updated on 5/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171100000X	Acupuncturist		1305	MINNESOTA	No
2	363LA2200X	Nurse Practitioner	Adult Health	R0713753	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	500002781	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA
2	R94989	MEDICARE UPIN	MINNESOTA
3	4927427-00	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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