Individual
JENNIFER REBECCA ENMAN-BOURGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
410 DEWEY ST, WISCONSIN RAPIDS, WI 54494-4715
(715) 423-6060
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
020045038
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
73626-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/07/2012
Last updated
02/26/2026
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