Provider Demographics
NPI:1861640831
Name:BRUNO-MOFU, CHERYL (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:BRUNO-MOFU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-9561
Mailing Address - Country:US
Mailing Address - Phone:760-921-5505
Mailing Address - Fax:
Practice Address - Street 1:1 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-9561
Practice Address - Country:US
Practice Address - Phone:760-921-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN041254163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development