Healthcare Provider Details

I. General information

NPI: 1295086205
Provider Name (Legal Business Name): DEBORAH LOU BRUNS CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBBIE BRUNS

II. Dates (important events)

Enumeration Date: 10/01/2012
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 DUTCHMANS LN
LOUISVILLE KY
40207-4714
US

IV. Provider business mailing address

6203 COVEY CT
FLOYDS KNOBS IN
47119-9421
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-1000
  • Fax:
Mailing address:
  • Phone: 502-541-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberDONA CERT #6752
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: