Individual provider Active NPI

Precious Faith Hasanon Porter, RN

  • Registered Nurse
  • Tolleson, AZ
National Provider Identifier
1124284542
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN153334 Issued in AZ
Practice address
9261 W Van Buren St
Tolleson, AZ 85353-2941
Phone
(623) 936-9740
Fax
(623) 907-5187
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN153334 AZ Primary

Addresses

Primary practice location

9261 W Van Buren St
Tolleson, AZ 85353-2941

Mailing address

9261 W Van Buren St
Tolleson, AZ 85353-2941
Phone (623) 936-9740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN153334AZMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1124284542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9261 W VAN BUREN ST",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853532941",
            "telephone_number": "623-936-9740",
            "fax_number": "623-907-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9261 W VAN BUREN ST",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853532941",
            "telephone_number": "623-936-9740",
            "fax_number": "623-907-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PRECIOUS FAITH",
        "middle_name": "HASANON",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN153334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolleson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.