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General NPI Number Information
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NPI Number | 1982705224
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Entity Type | Individual
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Provider Name | SANDRA J. BRUMMET FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1211 CORTINA DR
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City | ORLAND
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State | CA
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Zip | 95963-1699
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Country | US
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Telephone | 530-865-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 1658 N MILWAUKEE AVE # 100-1767
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City | CHICAGO
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State | IL
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Zip | 60647-6905
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Country | US
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Telephone | 217-652-0169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209-000577
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95003586
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License Number State | CA
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