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General NPI Number Information
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NPI Number | 1780771816
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Entity Type | Individual
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Provider Name | LAURA PORTER-GUYER PA
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Gender | Female
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 934 S BROADWAY ST STE C
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City | PORTLAND
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State | TN
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Zip | 37148-1718
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Country | US
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Telephone | 615-325-6446
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Fax | 615-325-2165
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Provider Business Mailing Address
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Address Line | 3024 BUSINESS PARK CIR
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3132
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Country | US
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Telephone | 615-239-2018
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00467
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License Number State | TN
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