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Individual

LATOSCA BRUNNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGAC-NP

Contact information

Practice address
4810 KEMP BLVD, WICHITA FALLS, TX 76308-5222
(872) 231-3162
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4017745
KY
363LA2100X
Acute Care Nurse Practitioner
309642
AZ
363LA2100X
Acute Care Nurse Practitioner
4017745
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
AP132721
TX
363LA2100X
Acute Care Nurse Practitioner
APRN11031715
FL

Other

Enumeration date
04/14/2017
Last updated
01/21/2026
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