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NPI Code Detail

MEDICARE: MELANIE H PORTER NP

MEDICARE:   MELANIE H PORTER  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner2956SC

General Provider Information

NPI Number : 1629187711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE H PORTER NP
Provider Business Mailing Address
First Line : 223 AUTRY AVE
Second Line :
City : CONWAY
State : SC
Zip : 29526-2359
Country : US
Telephone Number : 843-238-5654
Fax Number : 843-238-1624
Provider Business Practice Location Address
First Line : 1413 HIGHWAY 17 N
Second Line :
City : SURFSIDE BEACH
State : SC
Zip : 29575-6012
Country : US
Telephone Number : 843-238-5654
Fax Number : 843-238-1624
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ MELANIE H PORTER NP” Practice Location

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