Individual
MRS. CARMEN MICHELLE GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1989 MIAMISBURG CENTERVILLE RD, CENTERVILLE, OH 45459-3859
(937) 528-6890
Mailing address
1989 MIAMISBURG CENTERVILLE RD, CENTERVILLE, OH 45459-3859
(937) 528-6890
Taxonomy
Speciality
Code
Description
License number
State
364SW0102X
Women's Health Clinical Nurse Specialist
Primary
COA.13464-NP
OH
Other
Enumeration date
12/05/2012
Last updated
01/13/2013
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