Jessica Lynn Bugos
Nurse Practitioner Nurse Practitioner - Primary Care
180 S Main St
Canton
, Illinois 61520-2608
Jessica Lynn Bugos
Nurse Practitioner Nurse Practitioner - Primary Care
180 S Main St
Canton
, Illinois 61520-2608
(309) 647-0201
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Jessica Lynn Bugos
- 180 S Main St
- Canton, IL
- Zip : 61520-2608
- Phone : (309) 647-0201
Second Address
- Jessica Lynn Bugos
- 180 S Main St
- Canton, IL
- Zip : 61520-2608
- Phone : (309) 647-0201
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209018589 | IL |
| N | 363LP2300X | Nurse Practitioner - Primary Care | 209.018589 | IL |
National Provider Identifier
| NPI | 1063976058 |
|---|---|
| Provider Name | Jessica Lynn Bugos |
| First Address | Canton, IL 61520-2608 |
| Second Address | Canton, IL 61520-2608 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/01/2019 |
| Last Update Date | 07/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.