Provider Demographics
NPI:1821984253
Name:BRUNK, GABRIEL (APRN, CNP)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:BRUNK
Suffix:
Gender:M
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 LONGLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1453
Mailing Address - Country:US
Mailing Address - Phone:740-326-0499
Mailing Address - Fax:
Practice Address - Street 1:3454 LONGLEAF AVE
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45430-1453
Practice Address - Country:US
Practice Address - Phone:740-326-0499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0038791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily