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Individual

SHELLY BRUNNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1661 SOQUEL DR, BUILDING C, SANTA CRUZ, CA 95065-1709
(831) 476-3376
Mailing address
820 N DELAWARE ST, 206, SAN MATEO, CA 94401-1576
(650) 218-5830

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
13135
CA
363LW0102X
Women's Health Nurse Practitioner
13135
CA
367A00000X
Advanced Practice Midwife
1630
CA

Other

Enumeration date
10/10/2014
Last updated
10/10/2014
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