Individual provider Active NPI

Alyssa Bruce

  • Medical-Surgical Registered Nurse
  • Muskogee, OK
National Provider Identifier
1609763713
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
R0116968 Issued in OK
Practice address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone
(888) 397-8387
NPI assigned
Jun 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X R0116968 OK Primary

Addresses

Primary practice location

1011 Honor Heights Dr
Muskogee, OK 74401-1318

Mailing address

84 Village LN
Pryor, OK 74361-9554

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

State licenses

LicenseStateTypeSpecialty
R0116968OKMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1609763713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 VILLAGE LN",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743619554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 HONOR HEIGHTS DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011318",
            "telephone_number": "888-397-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OK",
            "license": "R0116968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.