Provider Demographics
NPI:1457996043
Name:BRUENING, LAURIE CATHERINE (CNP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:CATHERINE
Last Name:BRUENING
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:C
Other - Last Name:BRUENING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:12825 BIG CREEK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9809
Mailing Address - Country:US
Mailing Address - Phone:440-668-3725
Mailing Address - Fax:
Practice Address - Street 1:13207 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-7032
Practice Address - Country:US
Practice Address - Phone:440-285-6725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily