Healthcare Provider Details

I. General information

NPI: 1609592674
Provider Name (Legal Business Name): JENNIFER BRUMFIELD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N DIVISION ST STE A
MORRIS IL
60450-3122
US

IV. Provider business mailing address

1715 N DIVISION ST STE A
MORRIS IL
60450-3122
US

V. Phone/Fax

Practice location:
  • Phone: 815-942-1550
  • Fax: 815-942-8419
Mailing address:
  • Phone: 815-942-1550
  • Fax: 815-942-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209024233
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: