Healthcare Provider Details

I. General information

NPI: 1477603033
Provider Name (Legal Business Name): LUANN BRAMUCCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 OFFICE PARK DR
JACKSONVILLE NC
28546-3218
US

IV. Provider business mailing address

1229 AMBER PINES DR
LELAND NC
28451-9409
US

V. Phone/Fax

Practice location:
  • Phone: 910-353-2440
  • Fax:
Mailing address:
  • Phone: 203-767-0628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number001958
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: