Individual
JEANETTA ANN PORTER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
HOME HEALTH AIDE
Contact information
Practice address
2680 STATE ROUTE 545, MANSFIELD, OH 44903-9199
(419) 526-4240
Mailing address
2680 STATE ROUTE 545, MANSFIELD, OH 44903-9199
(419) 526-4240
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
2101175
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101175
—
OH
Enumeration date
03/10/2006
Last updated
07/09/2007
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