Provider Demographics
NPI:1396757639
Name:GASHUGI, OLGA M (NP)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:M
Last Name:GASHUGI
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4739 TIMBERLAND DR # 1
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1430
Mailing Address - Country:US
Mailing Address - Phone:269-471-2308
Mailing Address - Fax:
Practice Address - Street 1:3903 HOLLYWOOD RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9149
Practice Address - Country:US
Practice Address - Phone:269-408-1100
Practice Address - Fax:269-408-1329
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704144670363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M97600Medicare ID - Type Unspecified