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General NPI Number Information
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NPI Number | 1730146325
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Entity Type | Individual
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Provider Name | SHANDA BRUNER APRN
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Gender | Female
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 1915 WHITE AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-2300
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Country | US
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Telephone | 865-541-1720
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Fax | 865-541-2451
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Provider Business Mailing Address
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Address Line | 1915 WHITE AVE
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City | KNOXVILLE
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State | TN
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Zip | 37916-2300
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Country | US
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Telephone | 865-541-1720
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Fax | 865-541-2451
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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 | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | 59493
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License Number State | TN
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