Individual
MRS. GINA MARIE BRUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
720 MERCER PL, HUNTERSVILLE, NC 28078-2643
(704) 948-5681
Mailing address
720 MERCER PL, HUNTERSVILLE, NC 28078-2643
(704) 948-5681
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5500
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1290E
BCBS-NC
NC
05
—
7411762
—
NC
Enumeration date
06/09/2005
Last updated
12/09/2009
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