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Individual

MELINDA JILL PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, NNP-BC, CNS

Contact information

Practice address
2500 MERCED STREET, 3RD FLOOR, NICU, SAN LEANDRO, CA 94577-4201
(510) 454-3546
Mailing address
2500 MERCED STREET, 3RD FLOOR, NICU, SAN LEANDRO, CA 94577-4201
(510) 454-3546

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN536076
CA
363LN0005X
Critical Care Neonatal Nurse Practitioner
13535
CA
364SN0000X
Neonatal Clinical Nurse Specialist
Primary
1689
CA

Other

Enumeration date
10/25/2007
Last updated
11/12/2015
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