Provider Demographics
NPI:1891886644
Name:GUMP, LAUREN (OD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:GUMP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PUMPKIN CIR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-3129
Mailing Address - Country:US
Mailing Address - Phone:603-502-4593
Mailing Address - Fax:
Practice Address - Street 1:430 HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1011
Practice Address - Country:US
Practice Address - Phone:603-692-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH681152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU78063Medicare UPIN