| Doctor Name: | MRS. AMANDA WILSON BRUNS |
| NPI Number: | 1780083402 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1-109532 |
| Business Practice Address: | 232 Office Park Dr Gulf Shores, AL - 365423432 |
| Business Phone Number: | 2519682323 |
| Business Fax Number: | |
| Mailing Address: | 100 Culloden Ct, DOTHAN |
| State: | AL |
| Postal Code: | 363057204 |
| Phone Number: | 3346851425 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2014 |
| NPI Last Update Date: | 08/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 1-109532 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |