Individual
JESSICA L GUMULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5011
Mailing address
11781 LEE JACKSON MEMORIAL HWY, STE 550, FAIRFAX, VA 22033-3309
(571) 777-5164
(703) 890-2650
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
089088
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
89088
CT
Other
Enumeration date
09/14/2015
Last updated
09/30/2015
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