NPI | 1811225261 |
---|---|
Former Name | SUSAN K BRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277000841) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0997036-NP) |
363L00000X Nurse Practitioner (Licence: IL 209007903) | |
Enumeration Date | 2009-11-23 |
Last Update Date | 2024-12-09 |