MEDICARE: ANNA LOUISE BJORGUM FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN078672	AZ

General Provider Information

NPI Number	:	1841437910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA LOUISE BJORGUM FNP

Provider Business Mailing Address
First Line	:	82 S STONE AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-1713
Country	:	US
Telephone Number	:	520-792-3293
Fax Number	:

Provider Business Practice Location Address
First Line	:	1477 W COMMERCE CT
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-6016
Country	:	US
Telephone Number	:	520-881-1347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	05/23/2014

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