Individual
MR. GAVIN LEE FLENTGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
8 N FRENCH LN, PERRYVILLE, MO 63775-1577
(573) 768-6986
(949) 655-8621
Mailing address
8 N FRENCH LN, PERRYVILLE, MO 63775-1577
(573) 768-6986
(949) 655-8621
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2020019956
MO
Other
Enumeration date
07/02/2020
Last updated
08/10/2021
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