Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 01032764 | IN |
NPI | 1003898057 |
---|---|
Provider Name | Jane Gunsenhouser |
First Address | Indianapolis, IN 46207-7232 |
Second Address | Indianapolis, IN 46260-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100226300 | (05) | IN |
B29450 | (02) |