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NPI Code Detail

MEDICARE: MRS. SHIRLEY BROOK GUMM RN CPNP

MEDICARE: MRS. SHIRLEY BROOK GUMM RN CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner4173OH

General Provider Information

NPI Number : 1609833722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHIRLEY BROOK GUMM RN CPNP
Provider Business Mailing Address
First Line : 5 E LIBERTY ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-8202
Country : US
Telephone Number : 513-381-2247
Fax Number : 513-381-2256
Provider Business Practice Location Address
First Line : 5 E LIBERTY ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-8202
Country : US
Telephone Number : 513-381-2247
Fax Number : 513-381-2256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 07/05/2011

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