Individual
KIRSTIN ELLEN BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1020 EAST 1OTH STREET, ERIE, PA 16503-0002
(814) 453-4309
(814) 459-1191
Mailing address
5711 LUNA LN, ERIE, PA 16506-4719
(814) 453-4309
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
OS006234L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1696143
—
PA
Enumeration date
11/07/2005
Last updated
07/08/2007
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