Provider Demographics
NPI:1659679017
Name:BRUNOT, KOREEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:KOREEN
Middle Name:
Last Name:BRUNOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 HIGHLAND CT
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-3403
Mailing Address - Country:US
Mailing Address - Phone:678-787-8100
Mailing Address - Fax:
Practice Address - Street 1:74 HIGHLAND CT
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3403
Practice Address - Country:US
Practice Address - Phone:678-787-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 552770163W00000X, 163WC0400X, 163WC1600X, 163WG0600X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn