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General NPI Number Information
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NPI Number | 1962230607
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Entity Type | Individual
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Provider Name | BRUCHA WANOUNOU FNP
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 17 W 9TH ST
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City | BROOKLYN
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State | NY
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Zip | 11231-2501
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Country | US
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Telephone | 718-599-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 5317 MCKINLEY ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-4636
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Country | US
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Telephone | 929-271-2677
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F35469801
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License Number State | NY
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