Individual
JESSICA LYNN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1117 E HOME RD, SPRINGFIELD, OH 45503-2725
(937) 342-1619
Mailing address
1117 E HOME RD, SPRINGFIELD, OH 45503-2725
(937) 342-1619
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0037225
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0103850
—
OH
Enumeration date
01/28/2025
Last updated
12/01/2025
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