MRS. KATRINA LIN BRUCKER (NPI# 1427489822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427489822 |
| Entity Type | Individual |
| Full Name | MRS. KATRINA LIN BRUCKER |
| Credential | NP |
| Practice Address |
902 N Orange St Ste 202 Missoula MT 59802-2928 |
| Mailing Address |
Po Box 12 Liberty Lake WA 99019-0012 |
| Practice Telephone | 4063273362 |
| Mailing Telephone | 8667472455 |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2020-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5618-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NUR-APRN-LIC-157 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2809 N Park Drive Ln, Appleton, WI 549111603 | 9205211033 | |
| 320 S Walnut St, Appleton, WI 549115918 | 9208321649 | 9208321562 |
| Street Address |
902 N ORANGE ST STE 202 |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-2928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1093178626 | Kindnets Pllc | Nurse Practitioner | 622 W Bickford St, Missoula, MT 59801-3525 | 2016-03-31 |
| 1710598073 | Amanda Rae Holloron | Nurse Practitioner | 900 N Orange St Ste 102, Missoula, MT 59802-2951 | 2020-08-11 |
| 1033735063 | Evan Robert Thompson | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804-7424 | 2020-06-25 |
| 1669005526 | Heather Marie Judkins | Nurse Practitioner | 1315 Wyoming St, Missoula, MT 59801-1725 | 2020-02-19 |
| 1245885086 | Michael Charles Duchschere | Nurse Practitioner | 401 Railroad St W, Missoula, MT 59802-4109 | 2019-08-08 |
| 1366922551 | Sheila Ann Hurd | Nurse Practitioner | 401 Railroad St W, Missoula, MT 59802-4109 | 2018-08-16 |
| 1619419405 | Erin Flavin | Nurse Practitioner | 1511 S Russell St, Missoula, MT 59801 | 2016-11-09 |
| 1952853624 | Kristin Billingsley Toney | Nurse Practitioner | 900 N Orange St, Suite 102, Missoula, MT 59802-2998 | 2016-10-28 |
| 1881009892 | Andrea Dugan Skrocki | Nurse Practitioner | 2831 Fort Missoula Rd, Suite 206, Missoula, MT 59804-7419 | 2014-06-27 |
| Find all providers in MISSOULA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.