Fontenelle-Gilmer, Michelle A

Fontenelle-Gilmer, Michelle A is an sole proprietor health care provider with primary practice located at 3014 W Charleston Blvd Ste 130 , Las Vegas NV 89102-0083. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Fontenelle-Gilmer, Michelle A can be contacted via phone (702) 671-6475.

Contact Information

Primary practice address
3014 W Charleston Blvd Ste 130 Las Vegas NV 89102-0083
Phone: (702) 671-6475
Fax: (702) 671-6440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301077469 Michigan
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 15137 Nevada

Profile Details

NPI number 1053472449
LBN Legal business name Fontenelle-Gilmer, Michelle A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Jun 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053472449 NPPES
Michigan MEDICAID 4377332

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