Provider Demographics
NPI:1568276368
Name:PORTER, DIONNE NACO
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:NACO
Last Name:PORTER
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 1:4511 SYDENHAM RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-3751
Mailing Address - Country:US
Mailing Address - Phone:937-771-0071
Mailing Address - Fax:
Practice Address - Street 1:4511 SYDENHAM RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-3751
Practice Address - Country:US
Practice Address - Phone:937-771-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker