Nichole Lynn Bruno, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

803689 Issued in TX

Practice address

1300 N. Virginia Street
Port Lavaca, TX 77979

Phone

(361) 553-6844

Fax

(361) 553-7314

NPI assigned

Jul 24, 2007

Last updated

Nov 9, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Nichole Lynn Juarez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1326248592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N. VIRGINIA STREET",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "77979",
            "telephone_number": "361-553-6844",
            "fax_number": "361-553-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N. VIRGINIA STREET",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "77979",
            "telephone_number": "361-553-6844",
            "fax_number": "361-553-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "17282",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "803689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "604705",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "JUAREZ",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Renee Blackmon, PTA
• Olive Edwina Botor, PHARMD
• Kristi Boyd, FNP-C
• Stephen A Branch, RPH
• Victoria Leigh Brown, FNP-C
• Don Paul Bunnell, MD
• Kendra Anne Bunurai, DPT
• Autumn Busselle, COTA
• C.I.R.C.,P.a.
• Calhoun County (Calhoun County EMS)

• Nurse Practitioner in Port Lavaca, TX
• Providers in Port Lavaca, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.