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Individual

MS. CHRISTINA L BRUNING

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Mailing address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2002025630
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00055138
RAILROAD MEDICARE
MO
Enumeration date
05/17/2006
Last updated
07/08/2007
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