Provider Demographics
NPI:1780080200
Name:BRUN, JOYCE M (MPAS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:M
Last Name:BRUN
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:MISS
Other - First Name:JOYCE
Other - Middle Name:M
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, PA-C
Mailing Address - Street 1:1007 COURT YARD PLZ
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1838
Mailing Address - Country:US
Mailing Address - Phone:724-539-8517
Mailing Address - Fax:
Practice Address - Street 1:1007 COURT YARD PLZ
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1838
Practice Address - Country:US
Practice Address - Phone:724-539-8517
Practice Address - Fax:724-879-8024
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003415363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant