Individual
MISS SUSAN DEANN BRUNKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
372 CHALFONTE AVE, GROSSE POINTE FARMS, MI 48236-2910
(313) 885-6696
(313) 885-6696
Mailing address
372 CHALFONTE AVE, GROSSE POINTE FARMS, MI 48236-2910
(313) 885-6696
(313) 885-6696
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
4704157716
MI
163WH0200X
Home Health Registered Nurse
Primary
4704157716
MI
163WM0102X
Maternal Newborn Registered Nurse
4704157716
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704157716
STATE OF MICHIGAN RN LICENSE
MI
Enumeration date
12/16/2013
Last updated
12/16/2013
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