Individual
JEFFREY S PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
1301 TAYLOR ST STE 1A, COLUMBIA, SC 29201-2946
(803) 434-4790
(803) 434-4799
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(864) 522-8602
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP011089
PA
363LF0000X
Family Nurse Practitioner
Primary
20843
SC
Other
Enumeration date
02/11/2011
Last updated
11/22/2021
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