Individual
JESSICA R BUMGARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11282-33
WI
363LF0000X
Family Nurse Practitioner
8771
MN
363LF0000X
Family Nurse Practitioner
A164783
IA
Other
Enumeration date
09/02/2021
Last updated
11/29/2021
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