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Individual

CHRISTINE MARY BRUNNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
150 N EAGLE CREEK DR, LEXINGTON, KY 40509-1805
(859) 967-5000
Mailing address
PO BOX 633815, CINCINNATI, OH 45263-0001

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
O2895
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000480897
BCBS
KY
05
64117112
KY
01
P00286007
RAILROAD MEDICARE
KY
Enumeration date
07/28/2006
Last updated
03/30/2009
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