Doctor Name: | SHAWN GAUVIN |
NPI Number: | 1417302472 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | AG-ACNP |
License Number: | 4704212742 |
Business Practice Address: | 18128 Cedar Island Blvd Brownstown, MI - 481749582 |
Business Phone Number: | 3135493570 |
Business Fax Number: | |
Mailing Address: | 18128 Cedar Island Blvd, BROWNSTOWN |
State: | MI |
Postal Code: | 481749582 |
Phone Number: | 3135493570 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 4704212742 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |