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General NPI Number Information
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NPI Number | 1366255739
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Entity Type | Individual
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Provider Name | SARA HOPE PORTER RN
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Gender | Female
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 36065 SANTA FE AVE
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City | FORT CAVAZOS
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State | TX
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Zip | 76544-5060
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Country | US
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Telephone | 254-288-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 9205 FARRIER AVE
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City | KILLEEN
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State | TX
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Zip | 76542-6910
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Country | US
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Telephone | 817-583-2904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 1098396
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License Number State | TX
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