| Doctor Name: | MRS. AMANDA LYNN BRUSCHI |
| NPI Number: | 1033179106 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 1471 |
| Business Practice Address: | 1616 S Kelly Ave Edmond, OK - 730133651 |
| Business Phone Number: | 4053300015 |
| Business Fax Number: | 4053300092 |
| Mailing Address: | 1616 S Kelly Ave, EDMOND |
| State: | OK |
| Postal Code: | 730133651 |
| Phone Number: | 4053300015 |
| Fax Number: | 4053300092 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 12/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 1471 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |