Provider Demographics
NPI:1811887581
Name:BUMPUS, MARKETA
Entity type:Individual
Prefix:
First Name:MARKETA
Middle Name:
Last Name:BUMPUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 N ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2026
Mailing Address - Country:US
Mailing Address - Phone:765-282-9158
Mailing Address - Fax:
Practice Address - Street 1:3409 N ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2026
Practice Address - Country:US
Practice Address - Phone:765-282-9158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications