Provider Demographics
NPI:1588535686
Name:BRUCE TOTAL WELLNESS LLC
Entity type:Organization
Organization Name:BRUCE TOTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TASHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:231-638-3389
Mailing Address - Street 1:PO BOX 259
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60454-0259
Mailing Address - Country:US
Mailing Address - Phone:312-588-9449
Mailing Address - Fax:630-381-5279
Practice Address - Street 1:10544 S HARLEM AVE STE 208
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-2063
Practice Address - Country:US
Practice Address - Phone:312-588-9449
Practice Address - Fax:630-381-5279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty