Rhyder Bruce
Individual provider Active NPI Social Worker · Independence, KS
NPI 1861008633 · NPPES record last updated Sep 17, 2020
Key facts
- NPI
- 1861008633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 11908 (KS)
- Practice address
- 3751 W Main St
Independence, KS 67301-8446 - Phone
- (620) 331-1748
- NPI assigned
- Sep 17, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11908 | KS | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11908 | KS | Yes |
Addresses
Primary practice location
3751 W Main St
Independence, KS 67301-8446
Mailing address
PO Box 688
Independence, KS 67301-0688
Other providers in Independence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2020. 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.