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General NPI Number Information
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NPI Number | 1699150953
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Entity Type | Individual
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Provider Name | BRUNETTE BASTIEN ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 1425 VISCAYA PKWY STE 101
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City | CAPE CORAL
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State | FL
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Zip | 33990-3294
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Country | US
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Telephone | 239-919-4851
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Fax | 239-236-1200
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Provider Business Mailing Address
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Address Line | 1425 VISCAYA PKWY STE 101
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City | CAPE CORAL
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State | FL
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Zip | 33990-3294
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Country | US
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Telephone | 239-293-5829
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Fax | 239-236-1200
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 2971515
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9271515
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License Number State | FL
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