Individual
DR. JIM JARALENE PORQUEZ BANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
748 KENANSVILLE BYP, KENANSVILLE, NC 28349-9064
(910) 296-8080
Mailing address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024-00756
NC
Other
Enumeration date
04/16/2021
Last updated
03/19/2025
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