Provider Demographics
NPI:1609065002
Name:DE BRUN, NELYA V (DAOM, AP)
Entity Type:Individual
Prefix:DR
First Name:NELYA
Middle Name:V
Last Name:DE BRUN
Suffix:
Gender:F
Credentials:DAOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 W WOOLBRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7246
Mailing Address - Country:US
Mailing Address - Phone:561-932-3905
Mailing Address - Fax:
Practice Address - Street 1:3459 W WOOLBRIGHT RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7246
Practice Address - Country:US
Practice Address - Phone:561-932-3905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2398171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist