Individual
PRISCILLA BRUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
99-243 AIEA HEIGHTS DR, AIEA, HI 96701-3908
(808) 484-9165
Mailing address
99-243 AIEA HEIGHTS DR, AIEA, HI 96701-3908
(808) 484-9165
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
510-645
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510645
PROVIDER NUMBER
HI
Enumeration date
12/14/2006
Last updated
07/08/2007
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