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NPI Code Detail

MEDICARE: MRS. KIMBERLY COKER BRUNSTING NP

MEDICARE: MRS. KIMBERLY COKER BRUNSTING NP
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
1363L00000XNurse Practitioner1-078166AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00048664OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34084805OTHERTNBCBS
410071082OTHERTNAMERIGROUP COMMUNITY CARE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518959444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY COKER BRUNSTING NP
Provider Business Mailing Address
First Line : 2375 CHAMPIONS BLVD
Second Line : 3RD FLOOR
City : AUBURN
State : AL
Zip : 36830-6471
Country : US
Telephone Number : 334-528-5959
Fax Number : 334-528-5899
Provider Business Practice Location Address
First Line : 2375 CHAMPIONS BLVD
Second Line : 3RD FLOOR
City : AUBURN
State : AL
Zip : 36830-6471
Country : US
Telephone Number : 334-528-5959
Fax Number : 334-528-5899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 09/19/2016

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Directions to “ MRS. KIMBERLY COKER BRUNSTING NP” Practice Location

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