Healthcare Provider Details

I. General information

NPI: 1336652999
Provider Name (Legal Business Name): JANE BRUNO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 ESTATE DIAMOND RUBY
CHRISTIANSTED VI
00820-4435
US

IV. Provider business mailing address

PO BOX 7776
CHRISTIANSTED VI
00823-7776
US

V. Phone/Fax

Practice location:
  • Phone: 340-778-6311
  • Fax:
Mailing address:
  • Phone: 340-643-1389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP5900
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: