Provider Demographics
NPI:1134081565
Name:BRUNICK, AMBER MICHELLE (AGACNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MICHELLE
Last Name:BRUNICK
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8777 MOONSHIMMER TRL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-9170
Mailing Address - Country:US
Mailing Address - Phone:720-224-6865
Mailing Address - Fax:
Practice Address - Street 1:8210 SOUTHPARK TER
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5732
Practice Address - Country:US
Practice Address - Phone:720-914-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1000870-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care