Individual
MICHELLE GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 EDNA PL, MACON, GA 31204-4340
(478) 714-0425
Mailing address
1314 EDNA PL, MACON, GA 31204-4340
(478) 714-0425
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0030067566
GA
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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