Provider Demographics
NPI:1487818142
Name:BRUCE, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5512 SHADY CREEK CT
Mailing Address - Street 2:APT 24
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5512 SHADY CREEK CT
Practice Address - Street 2:APT 24
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1859
Practice Address - Country:US
Practice Address - Phone:763-477-8375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE815224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant