NPI 1407939200 · live from the CMS NPI Registry
Laurie Brunk, CPNP
Nurse Practitioner, Pediatrics in Wilmington, DE. National Provider Identifier 1407939200, active.
NPI record
| NPI | 1407939200 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1802 W 4th St, Wilmington, DE 19805 |
| Practice phone | 302-652-2455 |
| Mailing address | 2 Penns Way, Suite 412, New Castle, DE 19720 |
| Enumerated | October 23, 2006 |
| Last updated | April 6, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | LJ-0000153 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.