Individual
KSENIA BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 266-7856
(260) 266-5279
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71008129A
IN
Other
Enumeration date
07/02/2018
Last updated
08/11/2025
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