Provider Demographics
NPI:1891984050
Name:PORTER, ANN ELAINE (RN PHN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ELAINE
Last Name:PORTER
Suffix:
Gender:F
Credentials:RN PHN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2500 S C ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4560
Mailing Address - Country:US
Mailing Address - Phone:805-385-9438
Mailing Address - Fax:805-385-9145
Practice Address - Street 1:2500 S C ST
Practice Address - Street 2:SUITE C
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4560
Practice Address - Country:US
Practice Address - Phone:805-385-9438
Practice Address - Fax:805-385-9145
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA216062163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management