Healthcare Provider Details

I. General information

NPI: 1730423120
Provider Name (Legal Business Name): ROBERT LLOYD GAUNT F.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 N FRANKLIN ST
FRANKENMUTH MI
48734-1000
US

IV. Provider business mailing address

619 FAIRFIELD DR
FLUSHING MI
48433-1417
US

V. Phone/Fax

Practice location:
  • Phone: 989-652-9410
  • Fax:
Mailing address:
  • Phone: 480-689-1020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTAP4759
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: