Provider Demographics
NPI:1992263149
Name:PORRAS, LEONARAH LAVONNE (NP)
Entity type:Individual
Prefix:
First Name:LEONARAH
Middle Name:LAVONNE
Last Name:PORRAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7941 STARLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5847
Mailing Address - Country:US
Mailing Address - Phone:325-721-2817
Mailing Address - Fax:
Practice Address - Street 1:7941 STARLIGHT DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5847
Practice Address - Country:US
Practice Address - Phone:325-721-2817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily