Provider Demographics
NPI:1912398199
Name:BRULOTTE, NATALIE ROSE (FNP, ARNP, RN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:BRULOTTE
Suffix:
Gender:F
Credentials:FNP, ARNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-474-6661
Mailing Address - Fax:509-227-7070
Practice Address - Street 1:624 E FRONT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202
Practice Address - Country:US
Practice Address - Phone:509-626-9904
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60097820163W00000X
WAAP60517539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse