Provider Demographics
NPI:1225265093
Name:BRUNETT, NELDA M (RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:NELDA
Middle Name:M
Last Name:BRUNETT
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 CEDAR ELM DR
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-4985
Mailing Address - Country:US
Mailing Address - Phone:254-694-2450
Mailing Address - Fax:
Practice Address - Street 1:4800 LAKEWOOD DR
Practice Address - Street 2:SUITE 5
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2966
Practice Address - Country:US
Practice Address - Phone:254-772-7037
Practice Address - Fax:254-776-7188
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223246163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse