Healthcare Provider Details

I. General information

NPI: 1295116853
Provider Name (Legal Business Name): ANDREA BRUNE RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KOHLERS XING STE 310
KYLE TX
78640-2462
US

IV. Provider business mailing address

115 KOHLERS XING STE 310
KYLE TX
78640-2462
US

V. Phone/Fax

Practice location:
  • Phone: 512-312-5312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP126887
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: