Individual
CHRISTINE GALLARDO ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
33466 W 8 MILE RD, SUITE 168, FARMINGTON HILLS, MI 48335-5208
(248) 426-0110
Mailing address
2030 MEADOW RIDGE DR, COMMERCE TOWNSHIP, MI 48390-2657
(248) 508-7176
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704250488
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704250488
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704250488
NP LICENSE
MI
Enumeration date
12/17/2013
Last updated
07/15/2020
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