| Doctor Name: | MS. DEANA J PORTER |
| NPI Number: | 1134452568 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | |
| Business Practice Address: | 655 7th St Bldg 700700-a 78 Mdg/sgof Robins Afb, GA - 310982227 |
| Business Phone Number: | 4024797991 |
| Business Fax Number: | |
| Mailing Address: | 655 7th St Bldg 700700-a, 78 Mdg/sgof ROBINS AFB |
| State: | GA |
| Postal Code: | 310982227 |
| Phone Number: | 4024977793 |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2009 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |