Provider Demographics
NPI:1255855540
Name:MAHORO, PORSHIA ELISE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:PORSHIA
Middle Name:ELISE
Last Name:MAHORO
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:PORSHIA
Other - Middle Name:ELISE
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1588 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3729
Mailing Address - Country:US
Mailing Address - Phone:901-300-1562
Mailing Address - Fax:
Practice Address - Street 1:1588 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3729
Practice Address - Country:US
Practice Address - Phone:901-300-1562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily