MEDICARE: JENNIFER BRUNY MD

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	2086S0120X	Pediatric Surgery Physician	166507	AK
2	2086S0120X	Pediatric Surgery Physician	43866	CO

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	:	1801942495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BRUNY MD

Provider Business Mailing Address
First Line	:	4100 LAKE OTIS PKWY STE 312
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5231
Country	:	US
Telephone Number	:	907-929-7337
Fax Number	:	907-929-7330

Provider Business Practice Location Address
First Line	:	4100 LAKE OTIS PKWY STE 312
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5231
Country	:	US
Telephone Number	:	907-929-7337
Fax Number	:	907-929-7330

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	04/13/2021

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Directions to “ JENNIFER BRUNY MD” Practice Location

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