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NPI Code Detail

MEDICARE: MRS. LYNN ANN BRUCKER RN

MEDICARE: MRS. LYNN ANN BRUCKER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse371344-1NY

General Provider Information

NPI Number : 1558614347
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNN ANN BRUCKER RN
Provider Business Mailing Address
First Line : 777 MARYVALE DR
Second Line :
City : CHEEKTOWAGA
State : NY
Zip : 14225-2712
Country : US
Telephone Number : 716-631-9515
Fax Number : 716-631-9517
Provider Business Practice Location Address
First Line : 777 MARYVALE DR
Second Line :
City : CHEEKTOWAGA
State : NY
Zip : 14225-2712
Country : US
Telephone Number : 716-631-9515
Fax Number : 716-631-9517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2012
Last Update Date : 10/18/2012

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Directions to “ MRS. LYNN ANN BRUCKER RN” Practice Location

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