Provider Demographics
NPI:1396518916
Name:CARRINGTON-GREEN, PORTIA LAURICE
Entity type:Individual
Prefix:
First Name:PORTIA
Middle Name:LAURICE
Last Name:CARRINGTON-GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4663 HAYGOOD RD STE 215
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5442
Mailing Address - Country:US
Mailing Address - Phone:757-739-9100
Mailing Address - Fax:757-834-0883
Practice Address - Street 1:4663 HAYGOOD RD STE 215
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5442
Practice Address - Country:US
Practice Address - Phone:757-739-9100
Practice Address - Fax:757-834-0883
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide