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General NPI Number Information
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NPI Number | 1245191808
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Entity Type | Individual
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Provider Name | JASON LOUIS BURGUS
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Gender | Male
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 203 S MAPLE ST
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City | WINFIELD
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State | IA
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Zip | 52659-9707
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Country | US
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Telephone | 319-351-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 203 S MAPLE ST
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City | WINFIELD
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State | IA
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Zip | 52659-9707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 118291
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License Number State | IA
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