Individual provider · Type 1 NPI

Khadijah Desiree Brunner

Other Technician · White Bear Lake, MN

NPI number 1174282743 Active

Practice location

1011 Meadowlands Dr
White Bear Lake, MN 55127-2339

Call (612) 315-1976 Map

Mailing address

1008 Lawson Ave E
St. Paul, MN 55106-3328

Specialties and licenses

TaxonomyCodeLicense
Other Technician Primary 247200000XNone listed

Other Technician: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

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About NPI 1174282743

Khadijah Desiree Brunner's National Provider Identifier is 1174282743, issued on Dec 10, 2021. The primary taxonomy on file is Other Technician (247200000X), and the practice location is in White Bear Lake, MN. The record was last updated on Dec 12, 2021.