Provider Demographics
NPI:1043546724
Name:GEORGE, GISELE MARIE-ANNE (CNM)
Entity type:Individual
Prefix:MRS
First Name:GISELE
Middle Name:MARIE-ANNE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:475-220-3079
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-593-7500
Practice Address - Fax:313-593-8840
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704186167367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife