Individual
SHAWANNA BRUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP-BC
Contact information
Practice address
4097 STACY LN, SNELLVILLE, GA 30039-6199
(850) 933-0768
Mailing address
4097 STACY LN, SNELLVILLE, GA 30039-6199
(850) 933-0768
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
128792
GA
363LG0600X
Gerontology Nurse Practitioner
128792
GA
363LP2300X
Primary Care Nurse Practitioner
128792
GA
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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