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Contact Information

JERELYN J GUMERSON, NP
3834 S EMERSON AVE
BUILDING C, SUITE 100
INDIANAPOLIS, IN46203
 Phone: 317-782-1577
 Fax: 317-780-5539
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for JERELYN J GUMERSON · (Female)

NPI Number 1912970625
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 02/12/2006
Last updated 08/02/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 71000562A
  • IN Medicaid 200215810
  • IN Other P01424889 MEDICARE RAILROAD PIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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