Individual
CARLIE BROOKE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5833 GIDDYUP LN, FORT WORTH, TX 76179-7356
(432) 290-7960
Mailing address
5833 GIDDYUP LN, FORT WORTH, TX 76179-7356
(432) 290-7960
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
983236
TX
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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