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Individual

JEFFREY D BRUNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8248 S 96TH ST, LA VISTA, NE 68128-3126
(402) 717-9500
(402) 717-9501
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31071
NE
207Q00000X
Family Medicine Physician
RL13713
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12083
ND
Enumeration date
06/25/2015
Last updated
07/08/2020
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