Individual
JEANINE L BRUNCLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
235 STATE ST, SAINT CROIX FALLS, WI 54024-4117
(715) 483-3221
(715) 483-0507
Mailing address
235 STATE ST, SAINT CROIX FALLS, WI 54024-4117
(715) 483-3221
(715) 483-0507
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49004
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-23254
MEDICA
MN
01
—
080H9BR
BCBS MN PRO FEE
MN
05
—
34840300
—
WI
05
—
389435600
—
MN
01
—
501S5BR
BCBS MN FACILITY
MN
01
—
HP58527
HEALTHPARTNERS
MN
01
—
NA9031046087
PREFERRED ONE
MN
Enumeration date
10/24/2006
Last updated
12/31/2020
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