Provider Demographics
NPI:1801120902
Name:BRUTON, NICOLE (IOMT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BRUTON
Suffix:
Gender:
Credentials:IOMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 HALBRITE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3318
Mailing Address - Country:US
Mailing Address - Phone:714-615-1683
Mailing Address - Fax:
Practice Address - Street 1:1300 OAKRIDGE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5564
Practice Address - Country:US
Practice Address - Phone:877-377-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic