Provider Demographics
NPI:1396776886
Name:BRUCE, CHRISTINE ELAINE (RN)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ELAINE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELAINE
Other - Last Name:NEUMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2019 GRAFTON RD
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-897-1683
Mailing Address - Fax:
Practice Address - Street 1:2019 GRAFTON RD
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-8319
Practice Address - Country:US
Practice Address - Phone:440-897-1683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN133846163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2614399Medicaid