Doctor Name: | CATHY PORTER |
NPI Number: | 1154435741 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | F2731 |
Business Practice Address: | 1165 Highway 1 S Suite 400 Lugoff, SC - 290788966 |
Business Phone Number: | 8034083262 |
Business Fax Number: | 8034088895 |
Mailing Address: | 645 S Seventh St, Po Box 366 MC BEE |
State: | SC |
Postal Code: | 291017101 |
Phone Number: | 8433356756 |
Fax Number: | 8433358731 |
NPI Enumeration Date: | 08/19/2006 |
NPI Last Update Date: | 03/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F2731 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |