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NPI Code Detail

MEDICARE: MICHELLE MARY BUMGARDNER FNP-BC

MEDICARE:   MICHELLE MARY BUMGARDNER  FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerSP031667PA

General Provider Information

NPI Number : 1528369451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MARY BUMGARDNER FNP-BC
Provider Business Mailing Address
First Line : 50 E WYLIE AVE STE 123
Second Line :
City : WASHINGTON
State : PA
Zip : 15301-2059
Country : US
Telephone Number : 724-221-9712
Fax Number :
Provider Business Practice Location Address
First Line : 50 E WYLIE AVE STE 123
Second Line :
City : WASHINGTON
State : PA
Zip : 15301-2059
Country : US
Telephone Number : 724-221-9712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2010
Last Update Date : 07/09/2025

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Directions to “ MICHELLE MARY BUMGARDNER FNP-BC” Practice Location

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