Individual
DONNA MARIE GAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
799 HOMBACH ST, SAINT IGNACE, MI 49781-1735
(906) 298-8000
Mailing address
4601 E 12 MILE RD, SAULT SAINTE MARIE, MI 49783-9583
(260) 312-9853
(906) 984-2306
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703118247
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703118247
BOARD OF NURSING LPN
MI
Enumeration date
10/04/2019
Last updated
10/04/2019
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