Most Relevant Information
Provider Data
| NPI Number: | 1003267345 |
| Provider Name: | NICOLE MARIE BRUBAKER FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 33 340733 |
Most Important Dates
| Enumeration Date: | 06/28/2016 |
| Last Updated: | 04/10/2020 |
Provider Practice Location
124 SALISBURY ST
SANDY CREEK
NY
131457706
Practice Location Phone/Fax
| Phone: | 3153873620 |
| Fax: |
Provider Mailing Location
61 DELANO ST
PULASKI
NY
131421400
Provider Mailing Phone/Fax
| Phone: | 3152986564 |
| Fax: | 3152983968 |