Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | R 154604-2 | MN |
NPI | 1023288958 |
---|---|
Provider Name | Michelle Garay |
First Address | Brooklyn Park, MN 55443-1814 |
Second Address | Woodbury, MN 55125-1707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 31/12/2020 |