Basic Information
| Provider Information | |||||||||
| NPI: | 1043551963 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRUNING | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | DANIELLE | ||||||||
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| Credential: | TRT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7010 W 124TH ST | ||||||||
| Address2: | APT #1916 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662092025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6367956896 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4801 E LINWOOD BLVD | ||||||||
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| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641282226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8168614700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2013 | ||||||||
| LastUpdateDate: | 03/04/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471R0002X | 2204372 | KS | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiation Therapy |
No ID Information.