Provider Demographics
NPI:1356707020
Name:PUMPHREY, WILLIAM G (FNP-C)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:PUMPHREY
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10821 W GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8963
Mailing Address - Country:US
Mailing Address - Phone:812-371-3577
Mailing Address - Fax:
Practice Address - Street 1:246 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IN
Practice Address - Zip Code:47448-7009
Practice Address - Country:US
Practice Address - Phone:812-975-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28182074A163W00000X
IN71006021B363LF0000X
IN71006021A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse