Provider Demographics
NPI:1548505647
Name:BRUNS, JULIE ANN (RN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:BRUNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 19TH ST SOUTH
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377
Mailing Address - Country:US
Mailing Address - Phone:320-266-2152
Mailing Address - Fax:
Practice Address - Street 1:165 19TH ST SOUTH
Practice Address - Street 2:SUITE 102
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377
Practice Address - Country:US
Practice Address - Phone:320-266-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 90413-5174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator