Individual
ROBERT C BRUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-6111
(530) 926-0517
Mailing address
PO BOX 1618, FALLON, NV 89407-1618
(702) 419-0722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
000255
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005070601
—
AZ
Enumeration date
03/15/2006
Last updated
07/08/2007
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