Provider Demographics
NPI:1114655230
Name:PORTER, ROBBYN (CRNP)
Entity Type:Individual
Prefix:
First Name:ROBBYN
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ROBBYN
Other - Middle Name:ARLENE
Other - Last Name:FROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CORPORATE CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1758
Mailing Address - Country:US
Mailing Address - Phone:717-763-1174
Mailing Address - Fax:717-763-8960
Practice Address - Street 1:100 CORPORATE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1758
Practice Address - Country:US
Practice Address - Phone:717-763-1174
Practice Address - Fax:717-763-8960
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN325024L208800000X
PASP025872208800000X, 363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No208800000XAllopathic & Osteopathic PhysiciansUrology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner