Individual
PATRICIA JO VAN BRUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
950 BATTERY AVE SE STE 1216, ATLANTA, GA 30339-3094
(888) 663-6331
(415) 252-7176
Mailing address
1 EMBARCADERO CTR STE 1900, SAN FRANCISCO, CA 94111-3723
(888) 663-6331
(415) 252-7176
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6037
GA
363A00000X
Physician Assistant
C0010105
MD
363AM0700X
Medical Physician Assistant
MP00663
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006037
GEORGIA MEDICAL BOARD
GA
Enumeration date
02/15/2006
Last updated
08/26/2025
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