Individual provider Active NPI

Nicole Yvonne Bruno, RN, BSN

  • Registered Nurse
  • Vancouver, WA
National Provider Identifier
1184181984
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60765681 Issued in WA
Practice address
2502 E Fourth Plain Blvd
Vancouver, WA 98661-3965
Phone
(360) 852-9092
Fax
(360) 397-4368
NPI assigned
Feb 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X RN60765681 WA
Registered Nurse 163W00000X RN60765681 WA Primary

Addresses

Primary practice location

2502 E Fourth Plain Blvd
Vancouver, WA 98661-3965

Mailing address

1050 Larrabee Ave
Ste 104 PMB 466
Bellingham, WA 98225
Phone (360) 961-4941

Other practice location 1

4455 Cordata Pkwy
Bellingham, WA 98226-8037
Phone (360) 671-3225

Other identifiers 1

IdentifierTypeStateIssuer
2132995MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60765681WAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1184181984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LARRABEE AVE",
            "address_2": "STE 104 PMB 466",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-961-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 E FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613965",
            "telephone_number": "360-852-9092",
            "fax_number": "360-397-4368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 Cordata Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982268037",
            "country_code": "US",
            "telephone_number": "360-671-3225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "NICOLE",
        "middle_name": "YVONNE",
        "name_prefix": "Ms.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "RN60765681",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60765681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2132995",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.