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Contact Information

KRISTA M BRUCKER, MD
147 W GREEN MEADOWS DR STE 2
GREENFIELD, IN46140-4000
 Phone: 317-318-0367
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2083A0300X 84 Physician/Preventive Medicine
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for KRISTA M BRUCKER · (Female)

NPI # 1497076376
Status Active
Credentials MD
Entity Individual
Enumeration date 06/15/2010
Last updated 06/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IA License # MD-49601
  • IN License # 01071924A
  • IN Medicaid 201212140
Hospital affiliation(s)
  • MEMORIAL HOSPITAL OF SOUTH BEND - (Acute Care)
    615 N MICHIGAN ST
    SOUTH BEND, IN 46601
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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