Provider Demographics
NPI:1467012906
Name:EFFINGER, PORTIA CHINE (NP-C)
Entity type:Individual
Prefix:
First Name:PORTIA
Middle Name:CHINE
Last Name:EFFINGER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 PACES FERRY RD SE STE 170
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5705
Mailing Address - Country:US
Mailing Address - Phone:770-433-9437
Mailing Address - Fax:
Practice Address - Street 1:4300 PACES FERRY RD SE STE 170
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5705
Practice Address - Country:US
Practice Address - Phone:770-433-9437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN221028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily