Individual
MICAYLA GRACE GALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM, RN
Contact information
Practice address
5113 COUNTY ROAD M, WEST BEND, WI 53095-9751
(262) 483-0195
Mailing address
5113 COUNTY ROAD M, WEST BEND, WI 53095-9751
(262) 483-0195
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201248-30
WI
176B00000X
Midwife
Primary
303-49
WI
Other
Enumeration date
06/16/2014
Last updated
03/27/2024
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