Healthcare Provider Details

I. General information

NPI: 1134872062
Provider Name (Legal Business Name): AMY ELIZABETH BRUBAKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2022
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 MAYSVILLE RD
MOUNT STERLING KY
40353-9767
US

IV. Provider business mailing address

236 W MAIN ST
MOUNT STERLING KY
40353-1348
US

V. Phone/Fax

Practice location:
  • Phone: 859-404-7686
  • Fax: 859-274-4459
Mailing address:
  • Phone: 859-404-7686
  • Fax: 859-274-4459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3014206
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: