MEDICARE: ERIN L. BRUSS MSN, FN-C

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	363LF0000X	Family Nurse Practitioner	RN.399724	OH

General Provider Information

NPI Number	:	1093288409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN L. BRUSS MSN, FN-C

Provider Business Mailing Address
First Line	:	1300 W 9TH ST APT 1007
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1041
Country	:	US
Telephone Number	:	440-506-9306
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 W 9TH ST APT 1006
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1041
Country	:	US
Telephone Number	:	440-506-9306
Fax Number	:

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

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	01/08/2019

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