Individual
MICHELE L GLEASON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 N DIERS AVE, STE 2, GRAND ISLAND, NE 68803-4960
(308) 381-4733
(308) 381-6462
Mailing address
611 N DIERS AVE, STE 2, GRAND ISLAND, NE 68803-4960
(308) 381-4733
(308) 381-6462
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19617
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47082399313
—
NE
Enumeration date
06/13/2005
Last updated
07/08/2007
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