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Individual

MRS. KATRINA LIN BRUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
902 N ORANGE ST STE 202, MISSOULA, MT 59802-2928
(406) 327-3362
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(866) 747-2455

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
5618-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NUR-APRN-LIC-157587
MT

Other

Enumeration date
12/10/2013
Last updated
04/02/2020
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