Provider Demographics
NPI:1699572628
Name:PORTER, CARA DAWN (CPT)
Entity type:Individual
Prefix:PROF
First Name:CARA
Middle Name:DAWN
Last Name:PORTER
Suffix:
Gender:
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 NEWMAN LN
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:KS
Mailing Address - Zip Code:66073-5015
Mailing Address - Country:US
Mailing Address - Phone:785-979-2566
Mailing Address - Fax:
Practice Address - Street 1:8301 NEWMAN LN
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:KS
Practice Address - Zip Code:66073-5015
Practice Address - Country:US
Practice Address - Phone:785-979-2566
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 Licenses
StateLicense IDTaxonomies
KSN2G7F4H5246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy