Provider Demographics
NPI:1134452568
Name:PORTER, DEANA J (PA-C)
Entity type:Individual
Prefix:MS
First Name:DEANA
Middle Name:J
Last Name:PORTER
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:505 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31028-8613
Mailing Address - Country:US
Mailing Address - Phone:334-663-7366
Mailing Address - Fax:
Practice Address - Street 1:1925 E GLENN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5729
Practice Address - Country:US
Practice Address - Phone:334-528-0078
Practice Address - Fax:334-528-0079
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2024-06-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical