Healthcare Provider Details

I. General information

NPI: 1083524656
Provider Name (Legal Business Name): MRS. RHONDA GUMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W POPLAR ST
SIDNEY OH
45365-2773
US

IV. Provider business mailing address

507 3RD AVE
SIDNEY OH
45365-1119
US

V. Phone/Fax

Practice location:
  • Phone: 937-498-7249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number291942
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: