Provider Demographics
NPI:1619002458
Name:BRUMBAUGH, JANE ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ELLEN
Last Name:BRUMBAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 1ST STREET SW
Mailing Address - Street 2:MARIAN HALL MAIN 515
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-266-9397
Mailing Address - Fax:507-255-0602
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:MARIAN HALL MAIN 515
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-266-9397
Practice Address - Fax:507-255-0602
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2020-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA402442080N0001X
MN506122080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine