Provider Demographics
NPI:1730389743
Name:BRUNI, DAWN (ANP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BRUNI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 JACKSON MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1425
Mailing Address - Country:US
Mailing Address - Phone:615-874-9888
Mailing Address - Fax:615-883-6899
Practice Address - Street 1:244 JACKSON MEADOWS DR
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1425
Practice Address - Country:US
Practice Address - Phone:615-874-9888
Practice Address - Fax:615-883-6899
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01012 ANP363LF0000X
TN15960363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
R01885Medicare UPIN