Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1-082342 | AL |
N | 363LN0000X | Nurse Practitioner - Neonatal | 1082342 | AL |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1082342 | AL |
NPI | 1265790620 |
---|---|
Provider Name | Barbara Brutkiewicz |
First Address | Mobile, AL 36608 |
Second Address | Mobile, AL 36608-2497 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 24/04/2012 |