MEDICARE: BARBIE BRUNET ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP9302648	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9302648	FL
3	363LP2300X	Primary Care Nurse Practitioner	ARNP9302648	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174965438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBIE BRUNET ARNP

Provider Business Mailing Address
First Line	:	2504 ACORN ST STE A
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4746
Country	:	US
Telephone Number	:	772-837-7800
Fax Number	:	772-837-7801

Provider Business Practice Location Address
First Line	:	2504 ACORN ST STE A
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4746
Country	:	US
Telephone Number	:	772-837-7800
Fax Number	:	772-837-7801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2013
Last Update Date	:	06/21/2021

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