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Individual

KARI N. BRUENING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3375 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 343-5114
(309) 343-7859
Mailing address
3375 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 343-5114
(309) 343-7859

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
041340631
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
833610
MEDICARE GROUP PTAN
IL
01
CB6569
RR MEDICARE GROUP PTAN
IL
01
P00625331
RR MEDICARE MEMBER PTAN
IL
Enumeration date
07/07/2008
Last updated
11/03/2008
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