| NPI | 1780026419 |
|---|---|
| Former Name | SHANNON BRUNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 655) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: MN R1740327) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2023-03-01 |