NPI 1366996050 · live from the CMS NPI Registry
Tia Bruce, PNP
Nurse Practitioner, Pediatrics in Columbia, MO. National Provider Identifier 1366996050, active.
NPI record
| NPI | 1366996050 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 303 N Keene St, Suite 404, Columbia, MO 65201 |
| Practice phone | 573-777-7627 |
| Mailing address | 816 S Central Ave, Centralia, MO 65240 |
| Enumerated | August 10, 2016 |
| Last updated | August 10, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 2015044321 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.