Individual
JAMI NICOLE BURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
(920) 219-4009
Mailing address
233 W WISCONSIN AVE APT 310, OCONOMOWOC, WI 53066-5227
(262) 366-9141
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3889-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427506096
COMMERCIAL INSURANCES
WI
05
—
1427506096
—
WI
Enumeration date
09/13/2016
Last updated
03/26/2019
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