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NPI Code Detail

MEDICARE: JESSICA BRUNETTI

MEDICARE:   JESSICA  BRUNETTI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1134583842
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BRUNETTI
Provider Business Mailing Address
First Line : 2185 ROBERT ST
Second Line :
City : NORTH HUNTINGDON
State : PA
Zip : 15642-2962
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2185 ROBERT ST
Second Line :
City : NORTH HUNTINGDON
State : PA
Zip : 15642-2962
Country : US
Telephone Number : 724-953-2835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2016
Last Update Date : 04/08/2016

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Directions to “ JESSICA BRUNETTI ” Practice Location

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