Provider Demographics
NPI:1437123924
Name:WRIGHT-BRUCE, BARBARA A (FNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:WRIGHT-BRUCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 S MAIN ST
Mailing Address - Street 2:SOCIETY HILL
Mailing Address - City:SOCIETY HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29593-8972
Mailing Address - Country:US
Mailing Address - Phone:843-378-4501
Mailing Address - Fax:
Practice Address - Street 1:737 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SOCIETY HILL
Practice Address - State:SC
Practice Address - Zip Code:29593-8972
Practice Address - Country:US
Practice Address - Phone:843-378-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 2269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00939458OtherRAILROAD MEDICARE PTAN
SCNP0054Medicaid
SCAA67044784Medicare PIN
SCAA67041849Medicare PIN
SCAA6704Medicare UPIN
SCAA67041850Medicare PIN