Provider Demographics
NPI:1881605285
Name:PORTER, YOLANDA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PSC 103 BOX 1044
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09603-0011
Mailing Address - Country:US
Mailing Address - Phone:678-528-0387
Mailing Address - Fax:
Practice Address - Street 1:PSC 103 BOX 1044
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09603-0011
Practice Address - Country:US
Practice Address - Phone:678-528-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist