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Individual
CHARLIE MURPHY GANTT
Active
Individual
CHARLIE MURPHY GANTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP, AGPRN, PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
4704317868
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704317868
MI
363LP2300X
Primary Care Nurse Practitioner
4704317868
MI
Other
Enumeration date
04/29/2020
Last updated
05/08/2024
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