Individual
MS. KATHRYN MARIE BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
33155 ANNAPOLIS, EMERGENCY MEDICINE DEPARTMENT, WANE, MI 48184-2405
(734) 467-4042
(734) 467-5500
Mailing address
38935 ANN ARBOR ROAD, CREDENTIALING/PAYER CONTRACTING SERVICES, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704248262
MI
363LF0000X
Family Nurse Practitioner
4704248262
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11972106
CAQH
—
Enumeration date
08/25/2008
Last updated
06/29/2011
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