Individual
PROF. NANNETTE STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47714-0541
(812) 485-5612
(812) 485-5628
Mailing address
PO BOX 359, EVANSVILLE, IN 47703-0359
(812) 485-1220
(812) 485-8544
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040400A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283518
ANTHEM PROVIDER #
IN
05
—
100180890L
—
IN
05
—
100362820
—
IN
Enumeration date
06/07/2006
Last updated
03/08/2012
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