Peter John Brucker, RN
Registered Nurse in Salem, OR. Individual provider (NPI-1).
NPI number1720105968
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1720105968
- Entity type
- Individual (NPI-1)
- Name
- Mr. Peter John Brucker
- Credential
- RN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 23, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 090007635 | OR | Yes |
Practice location
3355 Deer Lake Ct SeSalem, OR 97301-9374
Phone 503-362-6091
Mailing address
Po Box 9323355 Deer Lake Ct Se
Salem, OR 97308-0932
Phone 503-362-6091
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