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General NPI Number Information
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NPI Number | 1679371249
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Entity Type | Individual
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Provider Name | SHANE CURTIS BRUNNER APRN, PPMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 201 S COLUMBUS ST
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City | LANCASTER
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State | OH
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Zip | 43130-4315
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Country | US
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Telephone | 740-687-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S COLUMBUS ST
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City | LANCASTER
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State | OH
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Zip | 43130-4315
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Country | US
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Telephone | 740-687-4500
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Fax | 740-687-4595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0039342
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 532991
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License Number State | OH
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