Provider Demographics
NPI:1720542558
Name:BRUNS, APRIL
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2844 SUNRAY LOOP
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6700
Mailing Address - Country:US
Mailing Address - Phone:208-731-3374
Mailing Address - Fax:
Practice Address - Street 1:1245 FILER AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-4118
Practice Address - Country:US
Practice Address - Phone:208-536-3975
Practice Address - Fax:208-293-8949
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered