Provider Demographics
NPI:1235903212
Name:PORTERFIELD, ANGELA DANETTE (RN BSN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DANETTE
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 NOTTINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3340
Mailing Address - Country:US
Mailing Address - Phone:864-650-7065
Mailing Address - Fax:
Practice Address - Street 1:209 OCONEE SQUARE DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-2546
Practice Address - Country:US
Practice Address - Phone:864-565-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC222416163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)