Kathleen B Bruce, RN IBCLC
Individual provider Active NPI Specialist · Williston, VT
NPI 1629237979 · NPPES record last updated Jun 3, 2008
Key facts
- NPI
- 1629237979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 3594 South Rd
Williston, VT 05495-8719 - Phone
- (802) 879-8854
- NPI assigned
- Jun 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
3594 South Rd
Williston, VT 05495-8719
Mailing address
3594 South Rd
Williston, VT 05495-8719
Phone (802) 879-8854
Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.