Individual
CYNTHIA L BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
298 MEMORIAL DR, SENECA, SC 29672-9443
(864) 882-3351
(864) 885-7619
Mailing address
PO BOX 2585, COLUMBUS, GA 31902-2585
(864) 882-0226
(706) 660-1454
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R31335
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1152
MEDICARE - GROUP
SC
01
—
400097
MEDICAID - GROUP
SC
05
—
AN0322
—
SC
05
—
GP2991
—
SC
Enumeration date
11/29/2005
Last updated
12/17/2007
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