Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 26704 | OK |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 41319-020 | WI |
NPI | 1053364224 |
---|---|
Provider Name | Cristin M Bruns |
First Address | Tulsa, OK 74133-5718 |
Second Address | Tulsa, OK 74133-5718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 22/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34386800 | (05) | WI |
60450 | DEAN HEALTH INSURANCE (01) | WI |
H87018 | (02) |