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NPI Code Detail

MEDICARE: BRIDGETTE MONIQUE PETERSON

MEDICARE:   BRIDGETTE MONIQUE PETERSON
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
1363LF0000XFamily Nurse Practitioner0024182741VA
2363L00000XNurse Practitioner0024182741VA

General Provider Information

NPI Number : 1942317557
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGETTE MONIQUE PETERSON
Provider Business Mailing Address
First Line : 1452 CHAIN BRIDGE RD
Second Line :
City : MC LEAN
State : VA
Zip : 22101-3706
Country : US
Telephone Number : 703-356-5900
Fax Number :
Provider Business Practice Location Address
First Line : 2311 WILSON BLVD FL 3
Second Line :
City : ARLINGTON
State : VA
Zip : 22201-5436
Country : US
Telephone Number : 804-571-2336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 01/28/2026

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Directions to “ BRIDGETTE MONIQUE PETERSON ” Practice Location

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