Provider Demographics
NPI:1134345697
Name:GAHAGAN, MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:GAHAGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1503
Mailing Address - Country:US
Mailing Address - Phone:615-340-5647
Mailing Address - Fax:615-340-2115
Practice Address - Street 1:311 23RD AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1503
Practice Address - Country:US
Practice Address - Phone:615-340-5647
Practice Address - Fax:615-340-2115
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN155999163WP0808X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health