Individual
MICHELE T GLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
15290 PENNOCK LN, APPLE VALLEY, MN 55124-7163
(952) 853-8800
(952) 431-6966
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10012
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42877600
—
WI
Enumeration date
02/02/2006
Last updated
03/18/2021
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