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General NPI Number Information
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NPI Number | 1407797863
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Entity Type | Individual
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Provider Name | SAFURATU AJAYI PORTER CRNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 1000 MOUNT OLIVET RD NE
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City | WASHINGTON
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State | DC
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Zip | 20002-2210
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Country | US
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Telephone | 202-576-7624
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Fax | 202-576-8457
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Provider Business Mailing Address
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Address Line | 12222 GUINEVERE RD
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City | GLENN DALE
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State | MD
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Zip | 20769-8936
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Country | US
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Telephone | 240-472-2197
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP500340003
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License Number State | DC
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