Basic Information
| Provider Information | |||||||||
| NPI: | 1295086205 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRUNS | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | LOU | ||||||||
| NamePrefix: | |||||||||
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| Credential: | CD(DONA) | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BRUNS | ||||||||
| OtherFirstName: | DEBBIE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6203 COVEY CT | ||||||||
| Address2: | |||||||||
| City: | FLOYDS KNOBS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471199421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025411081 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4001 DUTCHMANS LN | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028931000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2012 | ||||||||
| LastUpdateDate: | 10/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374J00000X | DONA CERT #6752 | Y | Nursing Service Related Providers | Doula |
No ID Information.