MEDICARE: JADA BRUCE

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
1	171M00000X	Case Manager/Care Coordinator	18585	LA

General Provider Information

NPI Number	:	1992664775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADA BRUCE

Provider Business Mailing Address
First Line	:	9327 VILLA CROSSING DR
Second Line	:
City	:	GREENWELL SPRINGS
State	:	LA
Zip	:	70739-4666
Country	:	US
Telephone Number	:	225-620-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	11616 SOUTHFORK AVE STE 403
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-5241
Country	:	US
Telephone Number	:	225-261-7143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ JADA BRUCE ” Practice Location

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