Provider Demographics
NPI:1790416147
Name:THOMAS BRUCE, MARCIA K (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:K
Last Name:THOMAS BRUCE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 GIBSON ST
Mailing Address - Street 2:
Mailing Address - City:DOLGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13329-1203
Mailing Address - Country:US
Mailing Address - Phone:315-985-5568
Mailing Address - Fax:
Practice Address - Street 1:352 GROS BLVD
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1446
Practice Address - Country:US
Practice Address - Phone:315-867-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY585259163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool