Provider Demographics
NPI:1255649919
Name:GACOSCOS, ELMA LOURDES BARBADO (APRN-BC)
Entity Type:Individual
Prefix:
First Name:ELMA LOURDES
Middle Name:BARBADO
Last Name:GACOSCOS
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 HURLEY PLZ
Mailing Address - Street 2:SON, 5TH FLOOR
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5902
Mailing Address - Country:US
Mailing Address - Phone:810-262-9353
Mailing Address - Fax:810-760-0440
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:SON, 5TH FLOOR
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9353
Practice Address - Fax:810-760-0440
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704199678363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily