| NPI | 1831786714 |
|---|---|
| Former Name | BRIDGET LYNN LOUCKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO C-APN.0004674-C-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-181042) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2023-01-22 |