Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704154118 | MI |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4704154118 | MI |
NPI | 1033357215 |
---|---|
Provider Name | Sean Michael Gargan |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2009 |
Last Update Date | 01/03/2017 |