Provider Demographics
NPI:1861475907
Name:BRUCIA, JOSEPHINE DEE (FNP)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:DEE
Last Name:BRUCIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19123 BEAR SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9332
Mailing Address - Country:US
Mailing Address - Phone:937-642-4808
Mailing Address - Fax:
Practice Address - Street 1:4961 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8129
Practice Address - Country:US
Practice Address - Phone:614-850-2407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily