Provider Demographics
NPI:1629098843
Name:BRUNA, ANNE C (ARNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:BRUNA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 MAY ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66508-1200
Mailing Address - Country:US
Mailing Address - Phone:785-562-3942
Mailing Address - Fax:785-562-5149
Practice Address - Street 1:1902 MAY ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66508-1200
Practice Address - Country:US
Practice Address - Phone:785-562-3942
Practice Address - Fax:785-562-5149
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS044850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100330000AMedicaid
KS160188OtherBC/BS KS
NE172944850Medicaid
KS641790OtherFIRST GUARD
KS160188OtherBC/BS KS
S70089Medicare UPIN