Individual
JACKIE ANNE BRUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 2ND AVE NW, PLAINVIEW, MN 55964-1222
(507) 951-3830
Mailing address
64751 141ST AVE, WABASHA, MN 55981-7592
(507) 450-7437
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
623212
MN
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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