Individual
AMY E BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 831-1766
(608) 828-4826
Mailing address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 831-1766
(608) 828-4826
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
38505
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34226900
—
WI
Enumeration date
07/27/2006
Last updated
03/06/2017
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