# DIANA LYNN GUMMO CRNP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740610583
- **Authorized official:** MRS. DIANA LYNN GUMMO CRNP (NURSE PRACTITIONER)
- **Authorized official phone:** (724) 433-6134

## Contact information

- **Practice address:** 607 N. CHURCH ST., SUITE 2, MT. PLEASANT, PA 15666
- **Practice address phone:** (724) 547-3200
- **Practice address fax:** (724) 547-3210
- **Mailing address:** 248 GREENBRIER RD, ACME, PA 15610-1234
- **Mailing address phone:** (724) 433-6134
- **Mailing address fax:** (724) 547-3210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | SP010666 | PA | Yes |

## Other

- **Enumeration date:** 11/14/2013
- **Last updated:** 11/14/2013