Individual
CONNIE M BRUCH-HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
(815) 748-8395
Mailing address
207 MERRY OAKS DR, SYCAMORE, IL 60178-8787
(815) 762-2365
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
041-226907
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
209-004518
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1013
AZ
Other
Enumeration date
08/10/2005
Last updated
11/08/2016
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