Provider Demographics
NPI:1750509659
Name:BUGGY, ELLEN M (NP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:BUGGY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:11321 N SAINT JAMES LN
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3046
Mailing Address - Country:US
Mailing Address - Phone:262-242-9150
Mailing Address - Fax:
Practice Address - Street 1:3351 N. DOWNER AVENUE
Practice Address - Street 2:3351N. DOWNER AVE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211
Practice Address - Country:US
Practice Address - Phone:414-229-4716
Practice Address - Fax:414-229-6608
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI425033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily