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General NPI Number Information
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NPI Number | 1811712623
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Entity Type | Individual
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Provider Name | JENNIFER A BUSHRE APRN, NP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1501 N OAKLAND AVE
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City | BOLIVAR
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State | MO
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Zip | 65613-3020
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Country | US
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Telephone | 417-326-7200
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Fax | 417-326-7201
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Provider Business Mailing Address
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Address Line | 2337 E CRAWFORD ST
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City | SALINA
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State | KS
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Zip | 67401-3713
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Country | US
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Telephone | 785-823-0633
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Fax | 844-854-4662
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024041849
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License Number State | MO
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