MARTHA EDIE BRUCKER AGPCNP - BC NPI 1164814281

NPI Information

NPI: 1164814281
Provider Name: MARTHA EDIE BRUCKER, AGPCNP - BC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER

PECOS Registration: Yes

Address:
5323 HARRY HINES BLVD
DALLAS, TX
ZIP 75390
Phone: (214) 645-4673
Get Directions

Martha Edie Brucker, AGPCNP - BC is an adult health nurse practitioner in Dallas, TX with 10 years of experience. Martha Edie Brucker, AGPCNP - BC NPI is 1164814281. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5323 HARRY HINES BLVD
DALLAS, TX
ZIP 75390-208
Phone: (214) 645-4673
Fax: (214) 645-7016

The NPI 1164814281 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/26/2015 and was last updated on 11/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	5007479	NORTH CAROLINA	No
2	363LA2200X	Nurse Practitioner	Adult Health	201338	NORTH CAROLINA	No
3	363LA2200X	Nurse Practitioner	Adult Health	AP131049	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	NP3256	MEDICAID	SOUTH CAROLINA
2	NCO055A	MEDICARE PIN	NORTH CAROLINA
3	1164814281	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »