MEDICARE: HEATHER N BRIDGEFORD CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	728900	TX
2	363LF0000X	Family Nurse Practitioner	AP124819	TX

General Provider Information

NPI Number	:	1497177166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER N BRIDGEFORD CNP

Provider Business Mailing Address
First Line	:	7909 FREDERICKSBURG RD STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3400
Country	:	US
Telephone Number	:	210-614-4544
Fax Number	:	210-679-3724

Provider Business Practice Location Address
First Line	:	7909 FREDERICKSBURG RD STE 210
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3400
Country	:	US
Telephone Number	:	210-614-4544
Fax Number	:	210-679-3717

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2014
Last Update Date	:	04/17/2025

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