Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 01042966A | IN |
Y | 111NI0900X | Internist | 01042966A | IN |
N | 207RG0300X | Geriatric Medicine | 01042966A | IN |
NPI | 1134102726 |
---|---|
Provider Name | Dr. Valerie Susan Bruemmer |
First Address | Lebanon, IN 46052 |
Second Address | Lebanon, IN 46052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 09/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100468100 | (05) | IN |
F57348 | (02) |