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Individual
MICHELLE BRUIN
Active
Individual
MICHELLE BRUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F10171409
NC
207Q00000X
Family Medicine Physician
Primary
RN1044808
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F10171409
AANP
—
Enumeration date
12/12/2017
Last updated
04/04/2019
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