Provider Demographics
NPI:1881129682
Name:PORTER, SARAH RUTH (NP-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:RUTH
Last Name:PORTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RUTH
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:4370 E EATON ALBANY PIKE
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:IN
Mailing Address - Zip Code:47338-8904
Mailing Address - Country:US
Mailing Address - Phone:765-623-6193
Mailing Address - Fax:
Practice Address - Street 1:2401 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3428
Practice Address - Country:US
Practice Address - Phone:765-751-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011332A363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily