Provider Demographics
NPI:1184017733
Name:BRUCE, DEBRA RUTH (LPN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:RUTH
Last Name:BRUCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-1153
Mailing Address - Country:US
Mailing Address - Phone:585-593-3240
Mailing Address - Fax:585-593-3336
Practice Address - Street 1:2 WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1153
Practice Address - Country:US
Practice Address - Phone:585-593-3240
Practice Address - Fax:585-593-3336
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292838164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse