| Doctor Name: | MRS. TARA MARIE BRUCE |
| NPI Number: | 1134415417 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 800130 |
| Business Practice Address: | 450 W Locke St Suite C Ashdown, AR - 718223326 |
| Business Phone Number: | 8708984100 |
| Business Fax Number: | |
| Mailing Address: | 450 W Locke St, Suite C ASHDOWN |
| State: | AR |
| Postal Code: | 718223326 |
| Phone Number: | 8708984100 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2011 |
| NPI Last Update Date: | 09/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 800130 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |