Provider Demographics
NPI:1568074888
Name:BRUTSCHE, AMBER NICOLE (RN)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:NICOLE
Last Name:BRUTSCHE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 E VILLA MARIA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1333
Mailing Address - Country:US
Mailing Address - Phone:602-885-4363
Mailing Address - Fax:
Practice Address - Street 1:1629 E VILLA MARIA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-1333
Practice Address - Country:US
Practice Address - Phone:602-885-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN193311163W00000X
AZ305342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse