Brunclik, Jeanine L

Brunclik, Jeanine L is an individual health care provider with primary practice located at 235 State St , Saint Croix Falls WI 54024-4117. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Brunclik, Jeanine L can be contacted via phone (715) 483-3221.

Contact Information

Primary practice address
235 State St Saint Croix Falls WI 54024-4117
Phone: (715) 483-3221
Fax: (715) 483-0507
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 49004 Wisconsin

Profile Details

NPI number 1689758237
LBN Legal business name Brunclik, Jeanine L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Dec 31st, 2020 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689758237 NPPES
Minnesota MEDICAID 389435600
Minnesota Other 080H9BR
Minnesota MEDICAID 34840300
Minnesota Other 01-23254
Minnesota Other NA9031046087
Minnesota Other 501S5BR
Minnesota Other HP58527

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