CHARLES ALLEN BRUCE (NPI# 1740646421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740646421 |
| Entity Type | Individual |
| Full Name | CHARLES ALLEN BRUCE |
| Other Name | AL BRUCE |
| Credential | FNP-C |
| Practice Address |
1238 Highway 42 Sumrall MS 39482-9519 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6017583100 |
| Practice Fax Number | 6017583060 |
| Mailing Telephone | 6017583100 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2020-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
901427 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09931583 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073821070 | Charles Fredrick Bruce | Pharmacist | 6935 Pines Rd, Shreveport, LA 71129-2515 | 2010-09-24 |
| 1730145657 | Charles O Bruce IIi | Ophthalmology | 301 E Muhammad Ali Blvd, Louisville, KY 40202-1511 | 2006-04-21 |
| 1811975980 | Charles Bruce | Internal Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2006-01-09 |
| 1609868140 | Charles E. Bruce | Optometrist | 901 E 3rd St, Washington, MO 63090-3010 | 2005-08-19 |
| Street Address |
1238 HIGHWAY 42 |
| City | SUMRALL |
| State | MS |
| Zip Code | 39482-9519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942217757 | John David Bullock | Family Medicine | 1238 Highway 42, Sumrall, MS 39482 | 2006-08-02 |
| 1326524646 | Jamie Elaine Thornton | Nurse Practitioner | 1238 Highway 42, Sumrall, MS 39482 | 2018-07-19 |
| 1700319860 | Joshua Lee Spake | Family Medicine | 1238 Highway 42, Sumrall, MS 39482-9519 | 2017-04-06 |
| 1518221175 | Lauren M Walters | Nurse Practitioner | 1238 Highway 42, Sumrall, MS 39482-9519 | 2012-06-28 |
| 1790871853 | Hattiesburg Clinic Pa | Family Medicine | 1238 Highway 42, Sumrall, MS 39482 | 2006-10-05 |
| 1285743468 | Sarah M Wainwright | Nurse Practitioner | 1238 Highway 42, Sumrall, MS 39482 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891255295 | Southern Saferide Transportation | Non-emergency Medical Transport (VAN) | 309 Hr Watts Road, Sumrall, MS 39482 | 2019-03-21 |
| 1346598380 | Serene Adult Care | Technician | 261 H.r. Watts Rd, Sumrall, MS 39482 | 2012-08-23 |
| 1346472628 | Patsy K Mcgrew | Counselor | 14 Ravenwood Lane, Sumrall, MS 39482 | 2009-08-20 |
| 1952572919 | Brett Alan Valentine D.m.d. | Dentist | 4864-b Hwy 589, Sumrall, MS 39482 | 2008-03-18 |
| 1205924834 | Medical Plus, LLC | Durable Medical Equipment & Medical Supplies | 4 Preston St, Sumrall, MS 39482 | 2006-10-10 |
| 1396844734 | Brett A Valentine | Dentist | 4864 B Hwy 589, Sumrall, MS 39482 | 2006-09-22 |
| 1881703429 | Kimberly R Schramm | Physical Therapist | 1240 Highway 42, Sumrall, MS 39482 | 2006-08-29 |
| 1871128934 | Brandon Scott Nesler | Pharmacist | 1109 Hwy 42, Sumrall, MS 39482 | 2020-03-10 |
| 1366004731 | Sumrall Drug Store LLC | Pharmacy | 1109 Hwy 42, Sumrall, MS 39482 | 2019-07-05 |
| 1598146136 | Hattiesburg Clinic, Pa | Physical Therapist | 1240 Highway 42, Sumrall, MS 39482 | 2015-06-09 |
| Find all providers in zip 39482 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326524646 | Jamie Elaine Thornton | Nurse Practitioner | 1238 Highway 42, Sumrall, MS 39482 | 2018-07-19 |
| 1417372400 | Pamela Jane Thompson | Nurse Practitioner | 348 Knight Rd, Sumrall, MS 39482-3702 | 2014-02-27 |
| 1285743468 | Sarah M Wainwright | Nurse Practitioner | 1238 Highway 42, Sumrall, MS 39482 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.