Individual
MRS. NICHOLE LYNN BRUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1300 N. VIRGINIA STREET, PORT LAVACA, TX 77979
(361) 553-6844
(361) 553-7314
Mailing address
1300 N. VIRGINIA STREET, PORT LAVACA, TX 77979
(361) 553-6844
(361) 553-7314
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17282
CA
363L00000X
Nurse Practitioner
Primary
803689
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604705
RN
CA
Enumeration date
07/24/2007
Last updated
11/09/2011
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