Provider Demographics
NPI:1346348927
Name:BRUCE, VALERIE ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:BRUCE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 15TH ST NW
Mailing Address - Street 2:104
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1620
Mailing Address - Country:US
Mailing Address - Phone:276-679-8890
Mailing Address - Fax:276-679-9740
Practice Address - Street 1:100 15TH ST NW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1616
Practice Address - Country:US
Practice Address - Phone:276-679-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24136307367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7439560900Medicaid
VA1346348927Medicaid
VA1346348927Medicaid
VA00X674N28Medicare PIN
007330C27Medicare ID - Type Unspecified