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General NPI Number Information
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NPI Number | 1750708335
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Entity Type | Individual
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Provider Name | BETTY S. BRUCE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 3015 CONNECTICUT AVE
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City | JOPLIN
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State | MO
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Zip | 64804-3035
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Country | US
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Telephone | 417-621-6634
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Fax | 417-634-3001
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Provider Business Mailing Address
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Address Line | 2508 S. WIND SONG AVE.
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City | SPRINGFIELD
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State | MO
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Zip | 65613-9141
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Country | US
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Telephone | 417-861-8261
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2014003279
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 2014113279
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2014003279
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License Number State | MO
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