Provider Demographics
NPI:1831488907
Name:BRUCE, TAVIA NIKASHA (CNA)
Entity Type:Individual
Prefix:MISS
First Name:TAVIA
Middle Name:NIKASHA
Last Name:BRUCE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 N CONGRESS AVE
Mailing Address - Street 2:APT E107
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-8202
Mailing Address - Country:US
Mailing Address - Phone:561-201-1409
Mailing Address - Fax:
Practice Address - Street 1:1820 N CONGRESS AVE
Practice Address - Street 2:APT E107
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-8202
Practice Address - Country:US
Practice Address - Phone:561-201-1409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA233580372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide