Provider Demographics
NPI:1225133259
Name:GAUCI, MICHELLE H (RD LDN CDE)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:H
Last Name:GAUCI
Suffix:
Gender:F
Credentials:RD LDN CDE
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Mailing Address - Street 1:1593 YANCEYVILLE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6948
Mailing Address - Country:US
Mailing Address - Phone:336-230-0402
Mailing Address - Fax:336-230-1761
Practice Address - Street 1:1593 YANCEYVILLE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6948
Practice Address - Country:US
Practice Address - Phone:336-230-0402
Practice Address - Fax:336-230-1761
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCL002236133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2993724Medicare ID - Type Unspecified