Individual provider · Type 1 NPI

Tia Bruce, PNP

Pediatric Nurse Practitioner · Columbia, MO

NPI number 1366996050 Active

Practice location

303 N Keene St, Suite 404
Columbia, MO 65201-7193

Call (573) 777-7627 Map

Mailing address

816 S Central Ave
Centralia, MO 65240-1810

Specialties and licenses

Taxonomy	Code	License
Pediatric Nurse Practitioner Primary	363LP0200X	2015044321 (MO)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1366996050

Tia Bruce, PNP's National Provider Identifier is 1366996050, issued on Aug 10, 2016. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Columbia, MO. The record was last updated on Aug 10, 2016.