Provider Demographics
NPI:1902589823
Name:BRUCE, ELISE (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 RIVERWALK DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-4668
Mailing Address - Country:US
Mailing Address - Phone:410-991-4371
Mailing Address - Fax:
Practice Address - Street 1:2191 DEFENSE HWY STE 201
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2469
Practice Address - Country:US
Practice Address - Phone:410-451-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR253187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily