Provider Demographics
NPI:1164126454
Name:BRUNS, DEBRA PETTIT (PHD, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:PETTIT
Last Name:BRUNS
Suffix:
Gender:F
Credentials:PHD, PMHNP-BC
Other - Prefix:DR
Other - First Name:DEBRA
Other - Middle Name:PETTIT
Other - Last Name:WHISENANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, PMHNP-BC
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-638-2914
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-070175363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health