Provider Demographics
NPI:1427237924
Name:BRUBACHER, ERIN K (ARNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:BRUBACHER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9825 SHANNON WOODS
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4100
Mailing Address - Country:US
Mailing Address - Phone:316-634-2000
Mailing Address - Fax:316-634-2582
Practice Address - Street 1:9825 SHANNON WOODS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4100
Practice Address - Country:US
Practice Address - Phone:316-634-2000
Practice Address - Fax:316-634-2582
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46066363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics