Individual
GERTRUDE MUMBA-KAUNDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 W WESTERN AVE, SOUTH BEND, IN 46619-3569
(574) 234-9033
(844) 397-1310
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(844) 397-1311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704248992
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71005367A
IN
Other
Enumeration date
12/09/2013
Last updated
12/01/2023
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