Provider Demographics
NPI:1376266361
Name:BRUMBAUGH, NICOLE L (MSN, CRNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:BRUMBAUGH
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:L
Other - Last Name:CARRIERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 DELAFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3205
Mailing Address - Country:US
Mailing Address - Phone:814-330-7070
Mailing Address - Fax:
Practice Address - Street 1:200 DELAFIELD RD STE 3010
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3214
Practice Address - Country:US
Practice Address - Phone:412-781-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026078363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner