Individual
JON W BUGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2011
Mailing address
1037 N 14TH ST, MANITOWOC, WI 54220-3234
(920) 652-0739
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
67956-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43403400
—
WI
Enumeration date
05/05/2006
Last updated
10/05/2011
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