Individual
MRS. LILLIAN JEAN BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1611 S BALTIMORE ST, KIRKSVILLE, MO 63501-4518
(660) 665-7575
(660) 665-7576
Mailing address
PO BOX 1239, HANNIBAL, MO 63401-1239
(573) 406-5888
(573) 248-5264
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
129740
IA
363LF0000X
Family Nurse Practitioner
Primary
2019001532
MO
Other
Enumeration date
12/28/2018
Last updated
01/17/2019
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