Individual
MICHELLE MARIE GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1004 S ROCK ST, GEORGETOWN, TX 78626-5837
(512) 374-1876
Mailing address
11509 VIA GRANDE DR, AUSTIN, TX 78739-1922
(512) 466-5222
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9227492
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306940100
—
FL
Enumeration date
04/06/2006
Last updated
09/29/2014
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