Provider Demographics
NPI:1184102519
Name:GENTSCH, MICHELLE LYNN (RN, AG-ACNP, BC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:GENTSCH
Suffix:
Gender:F
Credentials:RN, AG-ACNP, BC
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:MAKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3420 S MERCY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0425
Mailing Address - Country:US
Mailing Address - Phone:480-955-0900
Mailing Address - Fax:480-955-0800
Practice Address - Street 1:3420 S MERCY RD STE 300
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0425
Practice Address - Country:US
Practice Address - Phone:480-955-0900
Practice Address - Fax:480-955-0800
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN164877163WH1000X, 163WH1000X
AZ218028363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care