Provider Demographics
NPI:1699741355
Name:BRUEGGEMANN, JANE ELIZABETH (ANP-C)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELIZABETH
Last Name:BRUEGGEMANN
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11953 W LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-2756
Mailing Address - Country:US
Mailing Address - Phone:812-342-6198
Mailing Address - Fax:812-342-6198
Practice Address - Street 1:11953 W LOCUST LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-2756
Practice Address - Country:US
Practice Address - Phone:812-343-1050
Practice Address - Fax:812-512-1241
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001864A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health