Individual
KRISTA M BRUCKER
Active
Individual
KRISTA M BRUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01071924A
IN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
01071924A
IN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
MD-49601
IA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
01071924A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201212140
—
IN
Enumeration date
06/15/2010
Last updated
06/21/2022
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