Individual
STEPHANIE LANE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3721 S AMHERST HWY, MADISON HEIGHTS, VA 24572-5985
(434) 202-4318
(434) 300-5562
Mailing address
PO BOX 1187, MADISON HEIGHTS, VA 24572-1187
(434) 202-4318
(434) 300-5562
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024179655
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024179655
VA
Other
Enumeration date
09/04/2020
Last updated
01/07/2025
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