Individual
ANDREA LEAANNE GUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
77 W FOREST AVE, FLAGSTAFF, AZ 86001-1479
(574) 806-3190
Mailing address
1251 N PINE CLIFF DR APT 117, FLAGSTAFF, AZ 86001-3420
(574) 806-3190
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28211820A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
CNRA257352
AZ
Other
Enumeration date
06/14/2021
Last updated
09/03/2021
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