Provider Demographics
NPI:1831647940
Name:BRUNSVOLD, ABIGAIL CARMEN (DNP,APRN, CPNP-AC/PC)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:CARMEN
Last Name:BRUNSVOLD
Suffix:
Gender:F
Credentials:DNP,APRN, CPNP-AC/PC
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:CARMEN
Other - Last Name:BURKETT VETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP,APRN, CPNP-AC/PC
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 13TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3602
Practice Address - Country:US
Practice Address - Phone:701-234-3620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-18
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4785363LP0222X
NDR36417363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care