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Individual

JAMIE BUMGARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
280 E CORPORATE DR STE 200, MERIDIAN, ID 83642-2953
(208) 283-7314
Mailing address
945 E HEARTHSTONE DR, BOISE, ID 83702-1827

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6471067
ID

Other

Enumeration date
04/11/2025
Last updated
09/04/2025
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