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General NPI Number Information
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NPI Number | 1235903212
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Entity Type | Individual
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Provider Name | ANGELA DANETTE PORTERFIELD RN BSN
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Gender | Female
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 209 OCONEE SQUARE DR
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City | SENECA
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State | SC
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Zip | 29678-2546
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Country | US
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Telephone | 864-565-9821
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Fax |
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Provider Business Mailing Address
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Address Line | 132 NOTTINGHAM LN
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City | EASLEY
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State | SC
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Zip | 29640-3340
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Country | US
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Telephone | 864-650-7065
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Fax |
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 222416
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License Number State | SC
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