Brunner, Khadijah Desiree
Brunner, Khadijah Desiree is an individual health care provider with primary practice located at 1011 Meadowlands Dr , White Bear Lake MN 55127-2339. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as her primary health care specialty. Brunner, Khadijah Desiree can be contacted via phone (612) 315-1976.Contact Information
Primary practice address
1011 Meadowlands Dr
White Bear Lake MN 55127-2339
Phone: (612) 315-1976
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Technician, Other | 247200000X | Minnesota |
Profile Details
| NPI number | 1174282743 |
|---|---|
| LBN Legal business name | Brunner, Khadijah Desiree |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 10th, 2021 |
| Last updated | Dec 12th, 2021 - about 4 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.
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