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General NPI Number Information
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NPI Number | 1083599955
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Entity Type | Individual
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Provider Name | ASHLEY PORCH RN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 4348 ELECTRIC RD
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City | ROANOKE
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State | VA
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Zip | 24018-0720
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Country | US
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Telephone | 540-353-7273
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Fax | 540-857-5389
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Provider Business Mailing Address
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Address Line | 4348 ELECTRIC RD
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City | ROANOKE
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State | VA
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Zip | 24018-0720
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Country | US
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Telephone | 540-353-7273
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Fax | 540-857-5389
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 0001303327
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-313811
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License Number State | VA
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