Individual
MICHELLE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, WHNP-BC
Contact information
Practice address
221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 78150-4800
(210) 652-1836
Mailing address
221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 78150-4800
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
614476
TX
Other
Enumeration date
12/15/2005
Last updated
04/23/2018
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