Individual
MARYANN B BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
69 EXCHANGE ST W, SAINT PAUL, MN 55102-1004
(651) 735-0501
(651) 251-8050
Mailing address
245 RUTH ST N, SAINT PAUL, MN 55119-4323
(651) 735-0501
(651) 735-1870
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0575221
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401045100
—
MN
01
—
61G75BR
BCBS
MN
Enumeration date
09/21/2006
Last updated
02/25/2008
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