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NPI Code Detail

MEDICARE: BECKY BRUCE NP

MEDICARE: BECKY BRUCE NP
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
1163WG0000XGeneral Practice Registered Nurse174736TN
2363LF0000XFamily Nurse Practitioner22853TN

General Provider Information

NPI Number : 1073047189
Entity Type Code : Individual
Provider Name (Legal Business Name) : BECKY BRUCE NP
Provider Business Mailing Address
First Line : 221 STERLING FARM DR
Second Line :
City : JACKSON
State : TN
Zip : 38305-5727
Country : US
Telephone Number : 731-300-6155
Fax Number :
Provider Business Practice Location Address
First Line : 221 STERLING FARM DR
Second Line :
City : JACKSON
State : TN
Zip : 38305-5727
Country : US
Telephone Number : 731-300-6155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2017
Last Update Date : 10/20/2025

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