| Doctor Name: | MRS. PING JIN PORTER |
| NPI Number: | 1053611509 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | CNP-02025 |
| Business Practice Address: | 1443 Richmond Rd Cvs Minuteclinic Lyndhurst, OH - 441242449 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | |
| Mailing Address: | 2577 Bridgeton Dr, HUDSON |
| State: | OH |
| Postal Code: | 442361582 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2010 |
| NPI Last Update Date: | 06/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP-02025 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |