Individual
CHARLENE CARLETHA PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
114 FORCE DR, ALBANY, GA 31705-2531
(229) 291-6050
Mailing address
114 FORCE DR, ALBANY, GA 31705-2531
(229) 291-6050
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN313322
GA
163WH0200X
Home Health Registered Nurse
RN313322
GA
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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