Nicole Marie Brubaker
Nurse Practitioner - Family Medicine
124 Salisbury St
Sandy Creek
, New York 13145-7706
Nicole Marie Brubaker
Nurse Practitioner - Family Medicine
124 Salisbury St
Sandy Creek
, New York 13145-7706
(315) 298-3968
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Nicole Marie Brubaker
- 61 Delano St
- Pulaski, NY
- Zip : 13142-1400
- Fax : (315) 298-3968
- Phone : (315) 298-6564
Second Address
- Nicole Marie Brubaker
- 124 Salisbury St
- Sandy Creek, NY
- Zip : 13145-7706
- Phone : (315) 387-3620
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 33 340733 | NY |
National Provider Identifier
| NPI | 1003267345 |
|---|---|
| Provider Name | Nicole Marie Brubaker |
| First Address | Pulaski, NY 13142-1400 |
| Second Address | Sandy Creek, NY 13145-7706 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/06/2016 |
| Last Update Date | 10/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 04550890 | (05) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.