Bruining, Kersti
Bruining, Kersti is an sole proprietor health care provider with primary practice located at 1105 Sixth St , Traverse City MI 49684-2345. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Bruining, Kersti can be contacted via phone (231) 935-7514.Contact Information
Primary practice address
1105 Sixth St
Traverse City MI 49684-2345
Phone: (231) 935-7514
Fax: (231) 392-0039
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 4301062455 | Michigan |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 4301062455 | Michigan |
Profile Details
| NPI number | 1558364315 |
|---|---|
| LBN Legal business name | Bruining, Kersti |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Oct 5th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558364315 | NPPES |
| Michigan | Other | 4301062455 | STATE LICENSE NUMBER |
| Michigan | MEDICAID | 4618392 | STATE LICENSE NUMBER |
| Michigan | Other | 0281047 | STATE LICENSE NUMBER |
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