Provider Demographics
NPI:1194089425
Name:BRUNTZ, CARA R (NP)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:R
Last Name:BRUNTZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 15TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-4562
Mailing Address - Country:US
Mailing Address - Phone:970-810-0900
Mailing Address - Fax:970-810-3765
Practice Address - Street 1:1800 15TH ST STE 310
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-4562
Practice Address - Country:US
Practice Address - Phone:970-810-0900
Practice Address - Fax:970-810-3785
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO990425363LF0000X
CORXN.100829-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily