Provider Demographics
NPI:1710138235
Name:BRUCE, NANCY N (LVN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:N
Last Name:BRUCE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 SAN PASQUAL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-3918
Mailing Address - Country:US
Mailing Address - Phone:760-473-5665
Mailing Address - Fax:
Practice Address - Street 1:909 SAN PASQUAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3918
Practice Address - Country:US
Practice Address - Phone:760-473-5665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN174494164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse