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NPI Profile for TIMOTHY R LA GASSE in PETOSKEY, MI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Acute Care |
363LA2100X | 50 | Nurse Practitioner |
| NPI # | 1013424191 |
|
| Status | Active | |
| Credentials | NP (Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 01/10/2018 | |
| Last updated | 01/10/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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TIMOTHY R LA GASSE
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TIMOTHY R LA GASSE, NP