Individual
MRS. SHAVONNE MARIE GUMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
6111 HIGH BRIDGE RD, BOWIE, MD 20720-5216
(301) 503-1490
(301) 576-5197
Mailing address
4921 COLLINGTONS BOUNTY DR, BOWIE, MD 20720-5627
(240) 645-9037
(240) 645-9037
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R190102
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
636003300
—
MD
Enumeration date
08/20/2014
Last updated
03/01/2019
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