Healthcare Provider Details

I. General information

NPI: 1992106769
Provider Name (Legal Business Name): GWENDOLYN SUNKEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10967 ALLISONVILLE RD SUITE 240
FISHERS IN
46038-2632
US

IV. Provider business mailing address

600 CROSS POINTE RD SUITE A
GAHANNA OH
43230-6696
US

V. Phone/Fax

Practice location:
  • Phone: 317-436-1222
  • Fax: 317-288-0083
Mailing address:
  • Phone:
  • Fax: 614-577-1427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005143A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: