Provider Demographics
NPI:1275330185
Name:KNIFFIN, PORTIA LEANN
Entity type:Individual
Prefix:
First Name:PORTIA
Middle Name:LEANN
Last Name:KNIFFIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 HIGHWAY U
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:MO
Mailing Address - Zip Code:63650-7535
Mailing Address - Country:US
Mailing Address - Phone:573-310-3822
Mailing Address - Fax:
Practice Address - Street 1:3451 HIGHWAY U
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:MO
Practice Address - Zip Code:63650-7535
Practice Address - Country:US
Practice Address - Phone:573-310-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula