Individual
AMANDA DIANNE BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4360 SHORE DR STE 101, VIRGINIA BEACH, VA 23455-2994
(757) 251-0879
(984) 220-9437
Mailing address
4360 SHORE DR STE 101, VIRGINIA BEACH, VA 23455-2994
(757) 251-0879
(984) 220-9437
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
21324919
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5018262
NC
Other
Enumeration date
09/12/2022
Last updated
07/22/2025
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