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General NPI Number Information
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NPI Number | 1154163665
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Entity Type | Individual
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Provider Name | MRS. EMILY ADAH BRUCE
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Gender | Female
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 6100 S WALKER AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-7026
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Country | US
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Telephone | 405-634-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 12305 SW 7TH CIR
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City | YUKON
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State | OK
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Zip | 73099-6907
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Country | US
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Telephone | 405-317-9352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 135696
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License Number State | OK
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