Individual
EMILY PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 PALUXY RD, GRANBURY, TX 76048-5655
(817) 573-2273
Mailing address
351 MAIN ST, ATLANTIC BEACH, FL 32233-2529
(717) 307-0813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1180061
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1180061
TX
Other
Enumeration date
12/03/2024
Last updated
02/04/2025
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