Shirley A Bruner, LPN
Individual provider Active NPI Licensed Practical Nurse · Cascade, WI
NPI 1982882387 · NPPES record last updated Feb 7, 2008
Key facts
- NPI
- 1982882387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- Practice address
- W8961 Laurie LN
Cascade, WI 53011-1137 - Phone
- (920) 528-7588
- NPI assigned
- Feb 7, 2008
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305740-031 | WI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | WI | Yes |
Addresses
Primary practice location
W8961 Laurie LN
Cascade, WI 53011-1137
Mailing address
W8961 Laurie LN
Cascade, WI 53011-1137
Phone (920) 528-7588
Other providers in Cascade, WI
All providers in Cascade, WI · Licensed Practical Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2008. 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.