Provider Demographics
NPI:1972012060
Name:BUMPUS, JESSICA CROWELL (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CROWELL
Last Name:BUMPUS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 W GALENA BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-4305
Mailing Address - Country:US
Mailing Address - Phone:630-592-5960
Mailing Address - Fax:630-692-5961
Practice Address - Street 1:1901 W GALENA BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4305
Practice Address - Country:US
Practice Address - Phone:630-692-5960
Practice Address - Fax:630-692-5961
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277002020363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily