Individual
MICHELLE M. GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP, BC
Contact information
Practice address
505 GOPHER DR, TOMAH, WI 54660-4513
(608) 372-4111
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2057
WI
363LN0000X
Neonatal Nurse Practitioner
2057
WI
Other
Enumeration date
07/01/2011
Last updated
10/03/2022
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