Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 4704235966 | MI |
NPI | 1003119132 |
---|---|
Provider Name | Ms. Margaret Ann Gressle |
First Address | Fort Gratiot, MI 48059-3819 |
Second Address | Port Huron, MI 48060-3511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2010 |
Last Update Date | 17/03/2018 |