Individual
IRENE D GUMBOC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
99 STARR ST, NORWICH, CT 06360-4025
(860) 501-2725
Mailing address
99 STARR ST, NORWICH, CT 06360-4025
(860) 501-2725
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7550
CT
363LG0600X
Gerontology Nurse Practitioner
7550
CT
363LP2300X
Primary Care Nurse Practitioner
7550
CT
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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