Provider Demographics
NPI:1821572868
Name:BRUTON, KARYN KIMBERLY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:KIMBERLY
Last Name:BRUTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 N ROAN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3949
Mailing Address - Country:US
Mailing Address - Phone:423-557-5385
Mailing Address - Fax:
Practice Address - Street 1:1723 N ROAN ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3949
Practice Address - Country:US
Practice Address - Phone:423-557-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137931363LF0000X
TN24084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily