Gumerson, Jerelyn J.
Gumerson, Jerelyn J. is an individual health care provider with primary practice located at 3834 S Emerson Ave Building C, Suite 100, Indianapolis IN 46203. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gumerson, Jerelyn J. can be contacted via phone (317) 782-1577.Contact Information
Primary practice address
3834 S Emerson Ave Building C, Suite 100
Indianapolis IN 46203
Phone: (317) 782-1577
Fax: (317) 780-5539
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 71000562A | Indiana |
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | 71000562A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71000562A | Indiana |
Profile Details
| NPI number | 1912970625 |
|---|---|
| LBN Legal business name | Gumerson, Jerelyn J. |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2006 |
| Last updated | Aug 2nd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912970625 | NPPES |
| Indiana | Other | P01424889 | MEDICARE RAILROAD PIN |
| Indiana | MEDICAID | 200215810 | MEDICARE RAILROAD PIN |
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