Healthcare Provider Details

I. General information

NPI: 1275076556
Provider Name (Legal Business Name): LORIE GUMBS-TYLER ND, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7160 LASTING LIGHT WAY
COLUMBIA MD
21045-5138
US

IV. Provider business mailing address

7160 LASTING LIGHT WAY
COLUMBIA MD
21045-5138
US

V. Phone/Fax

Practice location:
  • Phone: 410-995-8066
  • Fax:
Mailing address:
  • Phone: 410-995-8066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number586
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberJ0000064
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND2200100
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: