Provider Demographics
NPI:1942811567
Name:BRUNT, VENESSA (CNA II)
Entity Type:Individual
Prefix:MS
First Name:VENESSA
Middle Name:
Last Name:BRUNT
Suffix:
Gender:F
Credentials:CNA II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 ORCHARD PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006
Mailing Address - Country:US
Mailing Address - Phone:336-995-1685
Mailing Address - Fax:336-941-9063
Practice Address - Street 1:271 ORCHARD PARK DRIVE
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006
Practice Address - Country:US
Practice Address - Phone:336-995-1685
Practice Address - Fax:336-941-9063
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health