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Individual

BRUCE LOWELL DEITSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(973) 600-6395
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0990381-NP
CO
364SF0001X
Family Health Clinical Nurse Specialist
APN.0990381-NP
CO

Other

Enumeration date
05/02/2012
Last updated
10/03/2024
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