Provider Demographics
NPI:1467545970
Name:GARNO, MICHAEL JOHN (RN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHN
Last Name:GARNO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WITTS END
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49238
Mailing Address - Country:US
Mailing Address - Phone:517-403-7003
Mailing Address - Fax:
Practice Address - Street 1:127 WITTS END
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:MI
Practice Address - Zip Code:49238
Practice Address - Country:US
Practice Address - Phone:517-403-7003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI47-04-226451163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4882895Medicaid