| Ms Surrell Porter, | |
|
1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | |
| (770) 473-0038 | |
| (770) 471-4290 |
| Full Name | Ms Surrell Porter |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 1287 Georgia Highway 138 Spur, Jonesboro, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467827402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN181538 (Georgia) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | RN181538 (Georgia) | Secondary |
| Entity Name | The Southeast Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
| Entity Name | Georgia Hospitalists Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033576376 PECOS PAC ID: 0840434866 Enrollment ID: O20130912000799 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Surrell Porter, 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 Ph: (770) 473-0038 | Ms Surrell Porter, 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 Ph: (770) 473-0038 |
Mrs. April D Joseph, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 236 Arrowhead Blvd, Jonesboro, GA 30236 Phone: 770-478-9240 |
Victoria Kelly Awuku, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1549 Iris Walk, Jonesboro, GA 30238 Phone: 470-209-3434 |
Phyllis A Kennedy-howell, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 239 Arrowhead Blvd, Jonesboro, GA 30236 Phone: 229-249-8687 Fax: 229-775-2223 |
Mrs. Mercy B Manga, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 Phone: 770-603-3649 Fax: 770-962-2400 |
Ms. Barbara R. Clark, APRN FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 962 Forest Gln, Jonesboro, GA 30238 Phone: 770-231-8568 Fax: 678-489-2348 |
Ms. Cristyle Lynn Morrison, ACNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8773 Channing Dr, Jonesboro, GA 30238 Phone: 678-262-7190 |
Myrna Gacusan, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6911 Tara Blvd, Jonesboro, GA 30236 Phone: 770-477-8573 Fax: 770-477-8573 |