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General NPI Number Information
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NPI Number | 1205293958
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Entity Type | Individual
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Provider Name | JENNIFER ROSBOROUGH PORTER NNP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1638 OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3424
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Country | US
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Telephone | 910-615-6762
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Fax |
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Provider Business Mailing Address
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Address Line | ATTN. MANAGED CARE PLANNING PO BOX 40908
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City | FAYETTEVILLE
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State | NC
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Zip | 28309
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Country | US
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Telephone | 910-615-6949
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Fax | 910-615-9761
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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 | 286500000X
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Taxonomy Name | Military Hospital
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License Number | 5006870
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 5006870
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License Number State | NC
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