Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 120070 | NE |
NPI | 1174052419 |
---|---|
Provider Name | Michelle Ann Gjere |
First Address | Omaha, NE 68107-1656 |
Second Address | Omaha, NE 68107-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2017 |
Last Update Date | 09/06/2017 |