Organization
KATHLEEN PORTER NP AND WILLIS-KNIGHTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG J. GAVIN (NETWORK ADMINISTRATOR)
(318) 212-3787
Entity
Organization
Contact information
Practice address
8001 YOUREE DR, SUITE 650, SHREVEPORT, LA 71115-2302
(318) 212-3787
(318) 212-3789
Mailing address
8001 YOUREE DR, SUITE 650, SHREVEPORT, LA 71115-2302
(318) 212-3787
(318) 212-3789
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/30/2006
Last updated
06/13/2008
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