Provider Demographics
NPI:1053038968
Name:BRUCE, JANICE MARIJKE (PHARMD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIJKE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 WILMER AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2403
Mailing Address - Country:US
Mailing Address - Phone:877-814-3475
Mailing Address - Fax:804-364-2809
Practice Address - Street 1:1030 WILMER AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2403
Practice Address - Country:US
Practice Address - Phone:877-814-3475
Practice Address - Fax:804-364-2809
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist