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General NPI Number Information
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NPI Number | 1114741584
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Entity Type | Individual
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Provider Name | CANDIA S GAUMER RN
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 720 S 6TH ST
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City | MONTICELLO
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State | IN
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Zip | 47960-8182
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Country | US
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Telephone | 574-583-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 6841 W CANAL ST
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City | LOGANSPORT
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State | IN
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Zip | 46947-7250
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Country | US
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Telephone | 765-210-8838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 28274933A
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License Number State | IN
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