Amanda Brulte, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN197324 Issued in GA

Practice address

100 Doctors Dr Ste 104
Douglas, GA 31533-2211

Phone

(912) 383-4352

Fax

(912) 384-1192

NPI assigned

Oct 23, 2014

Last updated

Oct 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Kid Doctor PC

  dba Brian Keith Childers MD

  • Pediatrics Physician
  • Douglas, GA
  • NPI 1235388786
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1063817872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE 104",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-383-4352",
            "fax_number": "912-384-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE 104",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-383-4352",
            "fax_number": "912-384-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRULTE",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN197324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallie S. Brigmond, PA-C
• Jessilee Gabrielle Brooker, DMD
• Justin Brown, PHARMACIST
• Mary Katherine Kemp Brown, CCC-SLP
• Matthew Jeremiah Brown, PHARMD
• Mark Thomas Brulte, MD
• Susan W Bryant, NP
• Jayla Snipes Bullock, SLP
• Kristin Margie Burnam, FNP-C
• Isadora Burnham, LMFT

• Family Nurse Practitioner in Douglas, GA
• Providers in Douglas, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.