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Individual
PRUNETTA O BRUNSON
Active
Individual
PRUNETTA O BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21737
SC
363LF0000X
Family Nurse Practitioner
Primary
0024185143
VA
363LF0000X
Family Nurse Practitioner
15259
WI
363LF0000X
Family Nurse Practitioner
21737
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5114
—
SC
Enumeration date
03/15/2018
Last updated
06/19/2025
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