Individual
MARK J BRUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, CRNP
Contact information
Practice address
1620 S. QUEEN ST. STE 2, YORK, PA 17403-4637
(800) 999-1249
(855) 656-7325
Mailing address
9800 SHELBYVILLE RD STE 220, LOUISVILLE, KY 40223-2992
(800) 999-1249
(855) 656-7325
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
UP005328B
PA
363LF0000X
Family Nurse Practitioner
R130259
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500014862
MEDICARE RR
MD
Enumeration date
10/10/2005
Last updated
05/23/2024
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