Individual
MICHELLE GAVIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14867 STONEY RIDGE LN, SKIATOOK, OK 74070
(918) 261-0802
Mailing address
14867 STONEY RIDGE LN, SKIATOOK, OK 74070
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R0103029
OK
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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