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NPI Code Detail

MEDICARE: LEAH JORDAN GUNDERMAN

MEDICARE: LEAH JORDAN GUNDERMAN
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
1367500000XCertified Registered Nurse Anesthetist1-181400AL

General Provider Information

NPI Number : 1841029865
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH JORDAN GUNDERMAN
Provider Business Mailing Address
First Line : 207 WOODMONT DR
Second Line :
City : RUSSELLVILLE
State : AL
Zip : 35653-5873
Country : US
Telephone Number : 256-665-2225
Fax Number :
Provider Business Practice Location Address
First Line : 830 S GLOSTER ST
Second Line :
City : TUPELO
State : MS
Zip : 38801-4996
Country : US
Telephone Number : 662-377-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2024
Last Update Date : 02/26/2026

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Directions to “ LEAH JORDAN GUNDERMAN ” Practice Location

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