Basic Information
Provider Information
NPI: 1992181119
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEHER
FirstName: EMILY
MiddleName: PORTER
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 SOUTHFIELD DR STE 1370
Address2:  
City: PLAINFIELD
State: IN
PostalCode: 461684300
CountryCode: US
TelephoneNumber: 3178375566
FaxNumber: 3178375567
Practice Location
Address1: 100 HOSPITAL LN STE 100
Address2:  
City: DANVILLE
State: IN
PostalCode: 461221993
CountryCode: US
TelephoneNumber: 3177457310
FaxNumber: 3177457320
Other Information
ProviderEnumerationDate: 08/11/2015
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X10001883AINY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home