Individual
JONATHON PETER PORTINCASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
120 QUAIL RUN, PINEHURST, NC 28374-9096
(231) 736-6541
Mailing address
120 QUAIL RUN, PINEHURST, NC 28374-9096
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024186941
VA
367500000X
Certified Registered Nurse Anesthetist
006290
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
331814
WI
Other
Enumeration date
01/07/2020
Last updated
07/10/2025
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