IndividualActive
Andrew Van Sumeren, SOTM, WP-C, NRP
NPI 1043006703 · Military Health Care Provider · Stennis Space Center, MS
Provider details
- NPI number
- 1043006703
- Entity type
- Individual
- Primary specialty
- Military Health Care ProviderOther Service Providers
- Credential
- SOTM, WP-C, NRP
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
2603 Lower Gainsville Road
Stennis Space Center, MS 39529-0001
Phone: (906) 440-8323
Approximate (ZIP-level) locationGet directions
Mailing address
353 State St
Bay St Louis, MS 39520-4433
Registry dates
- Enumerated
- 2025-04-17
- Last updated
- 2025-04-17
- Certified
- 2025-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.