Provider Demographics
NPI:1083778914
Name:MCCREA, BRUCE D (DC, FNP)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:D
Last Name:MCCREA
Suffix:
Gender:M
Credentials:DC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 E ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-1681
Mailing Address - Country:US
Mailing Address - Phone:252-757-0004
Mailing Address - Fax:252-757-0095
Practice Address - Street 1:216 E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5014
Practice Address - Country:US
Practice Address - Phone:252-757-0004
Practice Address - Fax:252-757-0095
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC879111N00000X
NC5004089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0836EOtherBLUE CROSS BLUE SHIELD
NC7000600Medicaid
NC0194LOtherAM. CHIROPRACTIC NETWORK
NC330594OtherCHIROPRACTIC NETWORK CARO
NC890836EMedicaid
NC561927871OtherCOMMERCIAL INSURANCE
NC2447427Medicare ID - Type Unspecified
NC890836EMedicaid