Provider Demographics
NPI:1316110729
Name:BRUCE, CATHY SUE (RN, BSN, CCE, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:SUE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:RN, BSN, CCE, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 HIGHWAY 78 E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-8907
Mailing Address - Country:US
Mailing Address - Phone:205-387-4858
Mailing Address - Fax:205-387-4678
Practice Address - Street 1:3400 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8907
Practice Address - Country:US
Practice Address - Phone:205-387-4858
Practice Address - Fax:205-387-4678
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-059127163WL0100X, 163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant