Individual
SHERYL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3100 COOPER ST, JACKSON, MI 49201-7545
(517) 780-6157
Mailing address
6977 PLACEWAY ST, JACKSON, MI 49201-9704
(517) 262-5226
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704169668
MI
363LF0000X
Family Nurse Practitioner
Primary
4704169668
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013452192
—
MI
Enumeration date
12/28/2016
Last updated
02/26/2017
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