Individual
JENNIFER GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
702 W LAKE LANSING RD, EAST LANSING, MI 48823-8526
(517) 332-5342
(517) 316-2893
Mailing address
2370 BROOKMEAD WAY, CHARLOTTE, MI 48813-8717
(269) 762-3128
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704259119
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704259119
LICENSE #
MI
Enumeration date
04/10/2015
Last updated
08/01/2023
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