Individual
MISS GAYLE WALDENMAIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
601 JOHN ST, KALAMAZOO, MI 49007
(269) 341-8253
(269) 341-7847
Mailing address
601 JOHN ST, KALAMAZOO, MI 49007-5341
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71002356A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000757295
ANTHEM
IN
05
—
300026288
—
IN
Enumeration date
01/30/2007
Last updated
07/26/2019
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