Provider Demographics
NPI:1801008685
Name:GOTCHER, MICHELLE J (LVN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:GOTCHER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:J
Other - Last Name:GOTCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:6557 GLENVIEW DR APT 1725
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8551
Mailing Address - Country:US
Mailing Address - Phone:817-793-0204
Mailing Address - Fax:
Practice Address - Street 1:6557 GLENVIEW DR APT 1725
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8551
Practice Address - Country:US
Practice Address - Phone:817-793-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08810164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse