Individual
MRS. ANGELA P GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
501 MEDICAL CENTER DR, SUITE 3A, ALEXANDRIA, LA 71301-8124
(318) 484-3899
(318) 484-3887
Mailing address
192 STILLEY RD, PINEVILLE, LA 71360-5933
(318) 484-3401
(318) 484-3402
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71598APO4777
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454877
—
LA
Enumeration date
08/23/2006
Last updated
02/02/2017
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