Individual
MRS. GINA A GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
215 W 4TH ST, MISHAWAKA, IN 46544-1917
(574) 325-5961
Mailing address
52854 HILL TRL, SOUTH BEND, IN 46628-9285
(574) 850-9545
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71012773A
IN
Other
Enumeration date
07/19/2022
Last updated
01/04/2026
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