Active NPI
Laurie Brunk, CPNP
- Pediatric Nurse Practitioner
- Wilmington, DE
National Provider Identifier
1407939200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- LJ-0000153
- Practice address
- 1802 W 4TH St
Wilmington, DE 19805 - Phone
- (302) 652-2455
- Fax
- (302) 322-6251
- NPI assigned
- Oct 23, 2006
- Last updated
- Apr 6, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | LJ-0000153 | DE | Primary |
Addresses
Primary practice location
1802 W 4TH St
Wilmington, DE 19805
Mailing address
2 Penns Way
Suite 412
New Castle, DE 19720
Phone (302) 652-2455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LJ-0000153 | DE | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459900800000",
"number": "1407939200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 PENNS WAY",
"address_2": "SUITE 412",
"city": "NEW CASTLE",
"state": "DE",
"postal_code": "19720",
"telephone_number": "302-652-2455",
"fax_number": "302-322-6251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 W 4TH ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "19805",
"telephone_number": "302-652-2455",
"fax_number": "302-322-6251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNK",
"first_name": "LAURIE",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2016-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "DE",
"license": "LJ-0000153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.