Provider Demographics
NPI:1831870161
Name:BRUCE, BRIDGET (APRN, CNP)
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 FOXFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-5799
Mailing Address - Country:US
Mailing Address - Phone:630-377-6500
Mailing Address - Fax:630-377-6577
Practice Address - Street 1:2900 FOXFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-5799
Practice Address - Country:US
Practice Address - Phone:630-377-6500
Practice Address - Fax:630-377-6577
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.027686363LF0000X
IL209027686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily