Donna L. Brunette, CRNA
Individual provider Active NPI Specialist · Spartanburg, SC
NPI 1760445803 · NPPES record last updated Oct 16, 2007
Key facts
- NPI
- 1760445803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- R67114 (SC)
- Practice address
- 720 N Pine St
Spartanburg, SC 29303-3127 - Phone
- (864) 560-5822
- Fax
- (864) 592-0586
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R67114 | SC | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crescent Anesthesia Associates | Past | Accepting new patients | |
| Ambulatory Anesthesia, LLC | Specialist | Past | Accepting new patients |
| Precision Anesthesia, LLC | Specialist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | R67114 | SC | Yes |
Addresses
Primary practice location
720 N Pine St
Spartanburg, SC 29303-3127
Mailing address
PO Box 4718
Spartanburg, SC 29305-4718
Phone (864) 592-0586
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AN0868 | Medicaid | SC |
Other providers in Spartanburg, SC
- Janis Sarah Browning
- Patricia P Browning
- Adam Kyle Brownlee
- Candace Bruce
- Bennett Howard Bruckner
- Danielle Bryan
- Amanda B Bryant
- Christian Noelle Bryson Le
- Monika Elisabeth Bryson
- Blaine David Buchanan
All providers in Spartanburg, SC · Specialist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2007. 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.