Healthcare Provider Details

I. General information

NPI: 1346348927
Provider Name (Legal Business Name): VALERIE ANN BRUCE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 15TH ST NW
NORTON VA
24273-1616
US

IV. Provider business mailing address

96 15TH ST NW 104
NORTON VA
24273-1620
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-9600
  • Fax:
Mailing address:
  • Phone: 276-679-8890
  • Fax: 276-679-9740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number24136307
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: