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General NPI Number Information
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NPI Number | 1710608336
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Entity Type | Individual
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Provider Name | JESSIE BUGBEE NP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 733 CEDAR ST
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City | GARBERVILLE
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State | CA
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Zip | 95542-3201
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Country | US
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Telephone | 707-923-2779
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 SHIVELY FLAT RD
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City | SCOTIA
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State | CA
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Zip | 95565-9710
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Country | US
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Telephone | 707-834-4838
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95020977
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License Number State | CA
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