Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | OS016286 | PA |
N | 2080P0216X | Pediatric Rheumatologist | OS016286 | PA |
NPI | 1487979407 |
---|---|
Provider Name | Emily Jean Brunner |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 06/08/2020 |