Provider Demographics
NPI:1679930648
Name:BRUNE, CHRISTOPHER K (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:K
Last Name:BRUNE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1180 RESURGENCE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7211
Mailing Address - Country:US
Mailing Address - Phone:706-543-5858
Mailing Address - Fax:706-621-5804
Practice Address - Street 1:1180 RESURGENCE DR
Practice Address - Street 2:STE 100
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7211
Practice Address - Country:US
Practice Address - Phone:706-543-5858
Practice Address - Fax:706-621-5804
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical