Provider Demographics
NPI:1215775572
Name:PORTER, AARIEL (LPN)
Entity type:Individual
Prefix:
First Name:AARIEL
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 N SHADELAND AVE STE J
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-5800
Mailing Address - Country:US
Mailing Address - Phone:317-939-9926
Mailing Address - Fax:
Practice Address - Street 1:3709 N SHADELAND AVE STE J
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5800
Practice Address - Country:US
Practice Address - Phone:317-939-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker