Individual
MRS. TARA KATHERINE BRUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
107 MCLEOD HEALTH BLVD STE 102, MYRTLE BEACH, SC 29579-4477
(843) 646-8430
(843) 646-8755
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-7120
(843) 777-7102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23700
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6787
—
SC
Enumeration date
02/12/2020
Last updated
01/19/2022
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