Katherine Anne Bruneau, R.N.
Individual provider Active NPI Registered Nurse · Molalla, OR
NPI 1649409129 · NPPES record last updated Jul 6, 2009
Key facts
- NPI
- 1649409129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 200141362RN (OR)
- Practice address
- 692 Columbia Dr
Molalla, OR 97038-8819 - Phone
- (503) 759-4997
- NPI assigned
- Jul 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200141362RN | OR | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 200141362RN | OR | Yes |
Addresses
Primary practice location
692 Columbia Dr
Molalla, OR 97038-8819
Mailing address
692 Columbia Dr
Molalla, OR 97038-8819
Phone (503) 759-4997
Other providers in Molalla, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.