| Doctor Name: | MRS. JENNIFER E PORTER |
| NPI Number: | 1205293958 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NNP |
| License Number: | 5006870 |
| Business Practice Address: | 2817 Reilly St Fort Bragg, NC - 283107324 |
| Business Phone Number: | 9109078922 |
| Business Fax Number: | |
| Mailing Address: | 2817 Reilly St, FORT BRAGG |
| State: | NC |
| Postal Code: | 283107324 |
| Phone Number: | 9109078922 |
| Fax Number: | |
| NPI Enumeration Date: | 01/26/2016 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | 5006870 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |