Healthcare Provider Details

I. General information

NPI: 1871766337
Provider Name (Legal Business Name): MELISSA CATHERINE PORTER R.N.,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 GARRISON DR
CINCINNATI OH
45231-2268
US

IV. Provider business mailing address

2330 GARRISON DR
CINCINNATI OH
45231-2268
US

V. Phone/Fax

Practice location:
  • Phone: 513-931-3134
  • Fax:
Mailing address:
  • Phone: 513-931-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN 324356
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: