Individual
MRS. MAUREEN ELIZABETH BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, PA-C
Contact information
Practice address
PO BOX 101, SAINT CLAIR, MI 48079-0101
(734) 309-7098
Mailing address
PO BOX 101, SAINT CLAIR, MI 48079-0101
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
896415
MI
363AM0700X
Medical Physician Assistant
Primary
5601004683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457397622
—
MI
Enumeration date
06/22/2006
Last updated
06/14/2024
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