NPI 1013100940
Shannon Porchia, SHIFTSUPVSRMHPP
Practice location
- Address
- 1628 E Page Ave, Malvern, AR 72104-4524
- Phone
- (501) 332-4437
- Mailing address
- PO Box 1589, Benton, AR 72018-1589
Registered specialties
Case Manager/Care Coordinator
Primary
Registry record
- NPI
- 1013100940
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 23 Aug 2007
- Record last updated
- 21 Jun 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.