Porter, Mary Ellen

Porter, Mary Ellen is an individual health care provider with primary practice located at 1020 River Oaks Dr Ste 100 , Flowood MS 39232-9511. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Porter, Mary Ellen can be contacted via phone (601) 326-8700.

Contact Information

Primary practice address
1020 River Oaks Dr Ste 100 Flowood MS 39232-9511
Phone: (601) 326-8700
Fax: (601) 932-4681
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN098282 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP04559 Louisiana

Profile Details

NPI number 1356489272
LBN Legal business name Porter, Mary Ellen
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Sep 11th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356489272 NPPES
Louisiana MEDICAID 437505741B

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