Healthcare Provider Details

I. General information

NPI: 1760706329
Provider Name (Legal Business Name): JAMIE MARIE BRUMMOND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE MARIE HANSEN

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 S MUCKEY ST BURGESS FAMILY CLINICS
MAPLETON IA
51034-1055
US

IV. Provider business mailing address

513 S MUCKEY ST BURGESS FAMILY CLINICS
MAPLETON IA
51034-1055
US

V. Phone/Fax

Practice location:
  • Phone: 712-882-2234
  • Fax: 712-822-2605
Mailing address:
  • Phone: 712-882-2234
  • Fax: 712-822-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF-118308
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: