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NPI Code Detail

MEDICARE: REBECCA PORTER

MEDICARE: REBECCA PORTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1568288587
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA PORTER
Provider Business Mailing Address
First Line : 4898 GUERLEY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-4038
Country : US
Telephone Number : 513-802-5060
Fax Number :
Provider Business Practice Location Address
First Line : 5118 CROOKSHANK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3304
Country : US
Telephone Number : 513-802-5060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2024
Last Update Date : 11/25/2024

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Directions to “ REBECCA PORTER ” Practice Location

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