Doctor Name: | LAURA ELLEN GULTEKIN |
NPI Number: | 1003200049 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, FNP-BC |
License Number: | 4704255971 |
Business Practice Address: | 555 Towner St Ypsilanti, MI - 481985752 |
Business Phone Number: | 7342557085 |
Business Fax Number: | |
Mailing Address: | 400 N Ingalls St, ANN ARBOR |
State: | MI |
Postal Code: | 481095482 |
Phone Number: | 7342557085 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2015 |
NPI Last Update Date: | 03/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704255971 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |