Individual
MICHELLE A FONTENELLE-GILMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9440 W SAHARA AVE STE 237, LAS VEGAS, NV 89117-8821
(702) 765-4965
Mailing address
9701 ROYAL LAMB DR, LAS VEGAS, NV 89145-8660
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301077469
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
15137
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4377332
—
MI
Enumeration date
12/12/2006
Last updated
01/06/2025
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