Provider Demographics
NPI:1871337022
Name:BRUNNER, CHEYANNE ALIENE RAE
Entity type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:ALIENE RAE
Last Name:BRUNNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:WAMEGO
Mailing Address - State:KS
Mailing Address - Zip Code:66547-0408
Mailing Address - Country:US
Mailing Address - Phone:785-456-9915
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 408
Practice Address - Street 2:
Practice Address - City:WAMEGO
Practice Address - State:KS
Practice Address - Zip Code:66547-0408
Practice Address - Country:US
Practice Address - Phone:785-456-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional