Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jennifer Leigh Defauw

Individual provider Nurse Practitioner · NPI 1548982812

Mrs. Jennifer Leigh Defauw is a Nurse Practitioner in Portage, Indiana. Qualified in 2022, 4 years ago. Practices with Porter Physician Services LLC, a 96-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
4
Licensed in
IN
In the registry since
2022

Practice location Address checks out

3156 Willowcreek Rd
Portage, IN 46368-4498
Phone: (219) 762-9444
Fax: (219) 762-2288
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1101 Glendale Blvd # 102a, Valparaiso, IN 46383-3767 — (219) 464-9521

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71013190A (IN)

Record details

NPI number1548982812
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 14, 2022
Last updated in NPPESJune 19, 2026
Certification dateJune 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Porter Physician Services Llc — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Portage