Individual
REBECCA SUE GUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1425
Mailing address
9030 MCCOMB RD, CHURUBUSCO, IN 46723-9441
(260) 693-9558
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000263A
IN
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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