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NPI Code Detail

MEDICARE: SHANDA BRUNER APRN

MEDICARE: SHANDA BRUNER APRN
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
1364SX0200XOncology Clinical Nurse Specialist59493TN

General Provider Information

NPI Number : 1730146325
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANDA BRUNER APRN
Provider Business Mailing Address
First Line : 1915 WHITE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37916-2300
Country : US
Telephone Number : 865-541-1720
Fax Number : 865-541-2451
Provider Business Practice Location Address
First Line : 1915 WHITE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37916-2300
Country : US
Telephone Number : 865-541-1720
Fax Number : 865-541-2451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 01/07/2015

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