Katharine Brucker

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP023044 Issued in PA

Practice address

3400 Spruce St
Philadelphia, PA 19104-4238

Phone

(215) 906-3875

NPI assigned

Nov 2, 2022

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1417664145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 MONROE AVE",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190382606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-906-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKER",
        "first_name": "KATHARINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP023044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Bruce, CRNA
• Patricia Renee Bruce, NP
• Joseph Bruchesky
• Lauren A Brucia, M.D.
• Alexander J Brucker, MD
• Benjamin Bruckman, LMT
• Janice Bruckner, PHD, PT
• Barbara Amy Brudnicki, MA, CCC-SLP
• Alyssa Kathleen Bruehlman, M.D.
• Caroline Clark Brugger, CRNP

• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.