Provider Demographics
NPI:1003638586
Name:BRUCE, BRITTNEY NICOLE (LPN)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:NICOLE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19003 FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1616
Mailing Address - Country:US
Mailing Address - Phone:216-532-6840
Mailing Address - Fax:
Practice Address - Street 1:19003 FAIRWAY AVE
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1616
Practice Address - Country:US
Practice Address - Phone:216-532-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.170959.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse