Brucker, Robert C

Brucker, Robert C is an individual health care provider with primary practice located at 914 Pine St , Mount Shasta CA 96067-2143. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Brucker, Robert C can be contacted via phone (530) 926-6111.

Contact Information

Primary practice address
914 Pine St Mount Shasta CA 96067-2143
Phone: (530) 926-6111
Fax: (530) 926-0517
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 000255 Nevada

Profile Details

NPI number 1073582854
LBN Legal business name Brucker, Robert C
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073582854 NPPES
Arizona MEDICAID 1005070601

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