Provider Demographics
NPI:1386846426
Name:WARWICK, BRUCE (RN)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:WARWICK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:20 UNIT 3RD STREET APT#102
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0112
Mailing Address - Country:US
Mailing Address - Phone:907-442-7455
Mailing Address - Fax:907-442-7245
Practice Address - Street 1:436 AND 5TH
Practice Address - Street 2:TED STEVENS WAY
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752-0043
Practice Address - Country:US
Practice Address - Phone:907-442-7455
Practice Address - Fax:907-442-7245
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK15568163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator