| NPI | 1578520557 |
|---|---|
| Former Name | SANDRA JEAN BRUBAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA R137019) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: GA R137019) |
| 163WG0000X Registered Nurse, General Practice (Licence: FL 2045242) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 2045242) | |
| 363L00000X Nurse Practitioner (Licence: GA R137019) | |
| 363L00000X Nurse Practitioner (Licence: FL 2045242) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2012-02-21 |