Individual
MICHELLE BRUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
415 S. 2ND STREET, WILMINGTON, NC 28401
(919) 381-8824
Mailing address
1342 FLORIDA AVE NW, WASHINGTON, DC 20009-4808
(919) 381-8824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F10171409
NC
207Q00000X
Family Medicine Physician
Primary
RN1044808
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F10171409
AANP
—
Enumeration date
12/12/2017
Last updated
04/04/2019
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