Provider Demographics
NPI:1881724730
Name:BREUNIG, MICHELLE (DNP, CNS, FNP-C)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:BREUNIG
Suffix:
Gender:F
Credentials:DNP, CNS, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46403-2405
Mailing Address - Country:US
Mailing Address - Phone:219-939-6070
Mailing Address - Fax:219-939-6090
Practice Address - Street 1:426 S LAKE ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46403-2405
Practice Address - Country:US
Practice Address - Phone:219-939-6070
Practice Address - Fax:219-939-6090
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN70000194B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041-332034OtherREGISTERED PRO. NURSE