Individual
DR. NANCY L BRUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4424
(918) 664-9892
(918) 664-2521
Mailing address
PO BOX 1867, FAYETTEVILLE, AR 72702-1867
(918) 664-9892
(918) 664-2521
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
118708
MO
207L00000X
Anesthesiology Physician
Primary
E-5371
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100317990B
—
MO
05
—
136770001
—
AR
05
—
200126940A
—
OK
05
—
203843420
—
MO
01
—
26178025
BCBS NUMBER
MO
01
—
771081401
ARKANSAS BREASTCARE
AR
01
—
P00664032
RAILROAD MEDICARE
AR
Enumeration date
05/04/2006
Last updated
10/09/2024
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