Bruda, Nancy L
Bruda, Nancy L is an individual health care provider with primary practice located at 3215 N Northhills Blvd , Fayetteville AR 72703-4424. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Bruda, Nancy L can be contacted via phone (918) 664-9892.Contact Information
Primary practice address
3215 N Northhills Blvd
Fayetteville AR 72703-4424
Phone: (918) 664-9892
Fax: (918) 664-2521
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 118708 | Missouri |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | E-5371 | Arkansas |
Profile Details
| NPI number | 1518915503 |
|---|---|
| LBN Legal business name | Bruda, Nancy L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Feb 10th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518915503 | NPPES |
| Missouri | MEDICAID | 100317990B | |
| Missouri | MEDICAID | 136770001 | |
| Missouri | Other | 771081401 | |
| Missouri | MEDICAID | 203843420 | |
| Missouri | Other | P00664032 | |
| Missouri | MEDICAID | 200126940A | |
| Missouri | Other | 26178025 |
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