Provider Demographics
NPI:1740080191
Name:GUNTER, SUMALIA DENISE (MEDICATION AIDE)
Entity type:Individual
Prefix:MRS
First Name:SUMALIA
Middle Name:DENISE
Last Name:GUNTER
Suffix:
Gender:
Credentials:MEDICATION AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-3328
Mailing Address - Country:US
Mailing Address - Phone:402-215-9421
Mailing Address - Fax:
Practice Address - Street 1:2738 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-3328
Practice Address - Country:US
Practice Address - Phone:402-215-9421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NE77031251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health