Individual
GERALYN M. EVON-GABOURIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3650 RAU RD, WEST BRANCH, MI 48661-9695
(734) 241-3891
(734) 241-0014
Mailing address
5623 E DUNBAR RD, MONROE, MI 48161-9127
(734) 241-3891
(734) 241-0014
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704168418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4308702180
BCBS PIN
MI
Enumeration date
01/12/2006
Last updated
03/13/2008
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