Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nickolaus Brunker

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1912473109

Nickolaus Brunker is a Student in an Organized Health Care Education/Training Program in Elkins Park, Pennsylvania. Licensed in Idaho. Registered with an NPI since 2018.

Licensed in
ID
In the registry since
2018
Specialties on file
2

Practice location Address checks out

2021 Mather Way Apt B
Elkins Park, PA 19027-1032
Phone: (208) 720-6809
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT-759 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1912473109
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 16, 2018
Last updated in NPPESOctober 21, 2020
Certification dateOctober 21, 2020
Mailing address2863 N Mountain Rd, Boise, ID 83702-0650

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