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General NPI Number Information
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NPI Number | 1720279185
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Entity Type | Individual
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Provider Name | STACY ZEIBER PORTER
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Gender | Female
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 501 MARKET ST
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City | LEWISBURG
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State | PA
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Zip | 17837-3002
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Country | US
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Telephone | 570-524-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 135 MAPLE AVE
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City | MILTON
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State | PA
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Zip | 17847-1607
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Country | US
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Telephone |
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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