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Individual

BRUCE P PRIVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1065 E BROAD ST, MONTICELLO, MS 39654-7703
(601) 587-4051
Mailing address
164A GAVIN RD, WIGGINS, MS 39577-9623
(228) 424-7060

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R739397
MS

Other

Enumeration date
02/28/2008
Last updated
01/18/2024
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