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Individual

MR. JASON SHANE BRUCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1401 MORRIS DR, OKMULGEE, OK 74447-6429
(918) 756-3177
Mailing address
18162 OLD MORRIS HWY, OKMULGEE, OK 74447
(918) 733-9824
(918) 733-9825

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2004003392
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
R 0085091
OK

Other

Enumeration date
06/29/2006
Last updated
07/09/2007
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