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

Tyler Allen Brundridge

Individual provider Acute Care Nurse Practitioner · NPI 1134715071

Tyler Allen Brundridge is a Nurse Practitioner in Edgewood, Kentucky. Qualified in 2020, 6 years ago. Practices with St Elizabeth Medical Center, Inc, a 186-clinician group and accepts Medicare assignment. Licensed in Kentucky and Ohio.

Years since qualifying
6
Licensed in
KY, OH
In the registry since
2020
Specialties on file
3

Practice location Address checks out

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone: (859) 301-9010
Fax: (859) 301-9018
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 3015580 (KY)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence APRN.CNP.0028121 (OH)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 3015580 (KY)

Record details

NPI number1134715071
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 15, 2020
Last updated in NPPESJuly 24, 2023
Certification dateJuly 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Elizabeth Medical Center, Inc — 186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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