Provider Demographics
NPI:1609860493
Name:BRUEHLER, LORI J (FNP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:J
Last Name:BRUEHLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:J
Other - Last Name:LINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:24811 WHITE CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-9528
Mailing Address - Country:US
Mailing Address - Phone:210-313-2665
Mailing Address - Fax:
Practice Address - Street 1:10000 ROGERS RUN ROAD
Practice Address - Street 2:KOHL'S WELLNESS CENTER
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-680-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP116442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily