Provider Demographics
NPI:1558626028
Name:BRUCE, MELISSA A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:BRUCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 W WHEELER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARANSAS PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78336-4522
Mailing Address - Country:US
Mailing Address - Phone:361-758-1599
Mailing Address - Fax:361-758-2227
Practice Address - Street 1:1401 W WHEELER AVE STE A
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4530
Practice Address - Country:US
Practice Address - Phone:361-758-1599
Practice Address - Fax:361-758-2227
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily