Individual
MRS. KATHERINE MARIE BRUYERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4490 WAYNE RD, MANTUA, OH 44255-9662
(330) 274-8242
Mailing address
4490 WAYNE RD, MANTUA, OH 44255-9662
(330) 274-8242
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
199361
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2632164
—
OH
Enumeration date
06/10/2009
Last updated
06/10/2009
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