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MANDY DE BRUIN APRN

Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1033789672

Individual Registrant:
 MANDY  DE BRUIN APRN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
30115 STATE ROAD 52 STE 101  SAN ANTONIO, FL 33576-8243 US
Tel: 813-467-4244  Fax: 813-467-4249

Contact information for business:
4085 SAGE DR  BEAUFORT, SC 29907-1536 US
Tel: 317-363-9112  Fax: --

Registration Information:
NPI: 1033789672
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Adult Health
SC24265
N363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
GAGAA-NP000003
Y363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
FLAPRN11013219

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS FL - Page 1



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