Provider Demographics
NPI:1518055862
Name:PORTER, HILDA EVANGELINE (RN, FNP, CNS)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:EVANGELINE
Last Name:PORTER
Suffix:
Gender:F
Credentials:RN, FNP, CNS
Other - Prefix:MISS
Other - First Name:HILDA
Other - Middle Name:EVANGELINE
Other - Last Name:MONAGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:8 CADILLAC DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5087
Mailing Address - Country:US
Mailing Address - Phone:713-560-6800
Mailing Address - Fax:
Practice Address - Street 1:8 CADILLAC DR
Practice Address - Street 2:SUITE 250
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5087
Practice Address - Country:US
Practice Address - Phone:713-560-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX424682363LF0000X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156854501Medicaid
TX156854501Medicaid
8A4594Medicare ID - Type Unspecified