Doctor Name: | SOMMER PORCH |
NPI Number: | 1306201611 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1-090211 |
Business Practice Address: | 1508 S Broad St Ste 300 Scottsboro, AL - 357682668 |
Business Phone Number: | 2562593600 |
Business Fax Number: | |
Mailing Address: | 1508 S Broad St Ste 300, SCOTTSBORO |
State: | AL |
Postal Code: | 357682668 |
Phone Number: | 2562593600 |
Fax Number: | |
NPI Enumeration Date: | 12/31/2015 |
NPI Last Update Date: | 12/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-090211 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |