Individual
GAYLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
102 N MAGDALEN ST, SAN ANGELO, TX 76903-5400
(325) 658-8643
(325) 658-8645
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 481-2165
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
573260
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N7133
BCBS OF TEXAS
TX
Enumeration date
08/30/2006
Last updated
06/01/2012
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