Healthcare Provider Details

I. General information

NPI: 1699606301
Provider Name (Legal Business Name): JESSICA PUHRMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 S PIETY ST # 1500
ELLSWORTH WI
54011-9117
US

IV. Provider business mailing address

445 S PIETY ST # 1500
ELLSWORTH WI
54011-9117
US

V. Phone/Fax

Practice location:
  • Phone: 715-273-3911
  • Fax:
Mailing address:
  • Phone: 715-273-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number134500-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: