Basic Information
| Provider Information | |||||||||
| NPI: | 1902983935 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PORTER | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | C.N.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 16948 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288160948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286708403 | ||||||||
| FaxNumber: | 8286708404 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 RIDGEFIELD CT | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286708403 | ||||||||
| FaxNumber: | 8286708404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SX0200X | 113825 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Oncology |
No ID Information.