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Individual

LAURA IRENE GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
525 S CENTER ST, HARTFORD, MI 49057-1362
(269) 463-3600
Mailing address
525 S CENTER ST, HARTFORD, MI 49057-1362

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704312241
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704312241
MICHIGAN NURSING LICENSE (NP)
MI
Enumeration date
02/11/2021
Last updated
12/01/2023
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