Healthcare Provider Details

I. General information

NPI: 1891607222
Provider Name (Legal Business Name): PORCHE GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 BAKER ST
MUSKEGON MI
49444-2157
US

IV. Provider business mailing address

2700 BAKER ST
MUSKEGON MI
49444-2157
US

V. Phone/Fax

Practice location:
  • Phone: 231-737-1335
  • Fax: 231-737-0534
Mailing address:
  • Phone: 231-737-1335
  • Fax: 231-737-0534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6851121536
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: