# JILL PORTER CRNP PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861948853
- **Authorized official:** JILL RENEE PORTER CRNP (OWNER)
- **Authorized official phone:** (410) 430-7247

## Contact information

- **Practice address:** 1310 BELMONT AVE, SUITE 302, SALISBURY, MD 21804-4506
- **Practice address phone:** (410) 430-7247
- **Practice address fax:** (443) 458-0661
- **Mailing address:** 1310 BELMONT AVE, SUITE 302, SALISBURY, MD 21804-4506
- **Mailing address phone:** (443) 953-1278
- **Mailing address fax:** (443) 458-0661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/30/2016
- **Last updated:** 01/10/2023