Provider Demographics
NPI:1174965438
Name:BRUNET, BARBIE (ARNP)
Entity type:Individual
Prefix:
First Name:BARBIE
Middle Name:
Last Name:BRUNET
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 ACORN ST STE A
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-4746
Mailing Address - Country:US
Mailing Address - Phone:772-837-7800
Mailing Address - Fax:772-837-7801
Practice Address - Street 1:2504 ACORN ST STE A
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4746
Practice Address - Country:US
Practice Address - Phone:772-837-7800
Practice Address - Fax:772-837-7801
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9302648363L00000X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104145500Medicaid