Provider Demographics
NPI:1174219018
Name:VERTUS-BRUCE, GESSIE ELNA (RN PC, RN-BSN)
Entity type:Individual
Prefix:
First Name:GESSIE
Middle Name:ELNA
Last Name:VERTUS-BRUCE
Suffix:
Gender:F
Credentials:RN PC, RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-5155
Mailing Address - Country:US
Mailing Address - Phone:239-961-5247
Mailing Address - Fax:
Practice Address - Street 1:84 FOREST AVE
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-5155
Practice Address - Country:US
Practice Address - Phone:239-961-5247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY717868163WM0705X, 163W00000X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse