Provider Demographics
NPI:1720855984
Name:BRUCE, AGNES (RN)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AGNES
Other - Middle Name:
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:938 FUCHSIA DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2365
Mailing Address - Country:US
Mailing Address - Phone:347-725-9537
Mailing Address - Fax:
Practice Address - Street 1:938 FUCHSIA DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2365
Practice Address - Country:US
Practice Address - Phone:347-725-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX870402163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse