Individual
JAN E BRUCKMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4050 LONESOME RD, STE A, MANDEVILLE, LA 70448-7085
(985) 246-2600
(985) 246-2601
Mailing address
4050 LONESOME RD, STE A, MANDEVILLE, LA 70448-7085
(985) 246-2600
(985) 246-2601
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP02518
LA
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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