Vanbommel, James G

Vanbommel, James G is an individual health care provider with primary practice located at 259 N Park Ave , Fond Du Lac WI 54935-3540. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Vanbommel, James G can be contacted via phone (920) 921-8528.

Contact Information

Primary practice address
259 N Park Ave Fond Du Lac WI 54935-3540
Phone: (920) 921-8528
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 126-033 Wisconsin

Profile Details

NPI number 1609904689
LBN Legal business name Vanbommel, James G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609904689 NPPES
Wisconsin MEDICAID 43418500

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