Provider Demographics
NPI:1366798670
Name:GARLOUGH, MICHELE COLLEEN (CNP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:COLLEEN
Last Name:GARLOUGH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29803 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3466
Mailing Address - Country:US
Mailing Address - Phone:419-467-0068
Mailing Address - Fax:
Practice Address - Street 1:1107 S MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-4703
Practice Address - Country:US
Practice Address - Phone:567-525-5081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2012013461363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily