Katie Sue Gump, RN

Individual provider Active NPI Registered Nurse · Woodside, CA

NPI 1831787878 · NPPES record last updated Jan 5, 2021

Key facts

NPI
1831787878
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
95102009 (CA)
Practice address
265 Greer Rd
Woodside, CA 94062-4205
Phone
(330) 240-4404
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95102009CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95102009 CA Yes

Addresses

Primary practice location

265 Greer Rd
Woodside, CA 94062-4205

Mailing address

265 Greer Rd
Woodside, CA 94062-4205

Other providers in Woodside, CA

All providers in Woodside, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.