Individual
JENNY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9851 BROOK RD, GLEN ALLEN, VA 23059-4559
(804) 893-8702
Mailing address
55 CANTRELL RD, STE 100, CLEVELAND, GA 30528-1083
(352) 258-4452
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110010102
VA
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
10/22/2010
Last updated
06/12/2025
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