Provider Demographics
NPI:1285885731
Name:BAGLEY, JESSICA LYNN (FNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:BAGLEY
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Gender:F
Credentials:FNP
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Mailing Address - Street 1:363 FREMONT STREET
Mailing Address - Street 2:#100
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017
Mailing Address - Country:US
Mailing Address - Phone:269-969-6100
Mailing Address - Fax:269-969-6102
Practice Address - Street 1:363 FREMONT STREET
Practice Address - Street 2:#100
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017
Practice Address - Country:US
Practice Address - Phone:269-969-6100
Practice Address - Fax:269-969-6102
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2022-03-03
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Provider Licenses
StateLicense IDTaxonomies
MI4704243656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily