Individual
SUSAN A BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1315 BURRO AVE, CLOUDCROFT, NM 88317-7719
(575) 682-2002
(575) 682-2003
Mailing address
PO BOX 1902, CLOUDCROFT, NM 88317-1902
(575) 921-2318
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP02684
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025174700
—
MD
05
—
99120330
—
NM
Enumeration date
06/29/2009
Last updated
09/28/2021
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