Provider Demographics
NPI:1003611872
Name:BRUNO, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BRUNO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10720 LINKWOOD CT APT 1224
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2952
Mailing Address - Country:US
Mailing Address - Phone:337-371-0399
Mailing Address - Fax:
Practice Address - Street 1:9001 SUMMA AVE STE 447
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3779
Practice Address - Country:US
Practice Address - Phone:225-763-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
114882251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic