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General NPI Number Information
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NPI Number | 1992524144
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Entity Type | Individual
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Provider Name | KATEY GIBSON PORTER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/05/2024
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 3811 NELSON SCHOOL RD
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City | MORRISTOWN
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State | TN
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Zip | 37813-4429
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Country | US
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Telephone | 423-300-0568
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Fax |
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Provider Business Mailing Address
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Address Line | 6890 W ANDREW JOHNSON HWY
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City | TALBOTT
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State | TN
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Zip | 37877-8610
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Country | US
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Telephone | 423-839-2120
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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 | 6216
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License Number State | TN
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