Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 4301090247 | MI |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 58728 | MN |
NPI | 1659579712 |
---|---|
Provider Name | Dr. Emily A. Brunner |
First Address | Eagan, MN 55122-1451 |
Second Address | Eagan, MN 55122-1451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 22/09/2021 |