Provider Demographics
NPI:1861762783
Name:BRUNNER, KATHRYN MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:BRUNNER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MARIE
Other - Last Name:HEIDORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3508 HARBORWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4391
Mailing Address - Country:US
Mailing Address - Phone:615-594-4030
Mailing Address - Fax:
Practice Address - Street 1:LHI NASHVILLE
Practice Address - Street 2:1718 CHARLOTTE AVE COMPENSATION & DISABILITY PHYSICALS
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-848-0100
Practice Address - Fax:615-891-4528
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16365363LF0000X
TXAP144118363LF0000X
TNAPN0000016365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily