Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704239149 | MI |
N | 363LA2200X | Nurse Practitioner - Adult Health | 4704239149 | MI |
N | 363LC1500X | Nurse Practitioner - Community Health | 4704239149 | MI |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704239149 | MI |
NPI | 1568567154 |
---|---|
Provider Name | Mrs. Michele Lynn Gargan |
First Address | Ann Arbor, MI 48105-1554 |
Second Address | Ann Arbor, MI 48105-1554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 24/09/2012 |