Healthcare Provider Details

I. General information

NPI: 1922877786
Provider Name (Legal Business Name): COURTNEY BRIDGES MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 01/12/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 SE 17TH ST STE 100
OCALA FL
34471-5588
US

IV. Provider business mailing address

2640 SW 32ND PL
OCALA FL
34471-7847
US

V. Phone/Fax

Practice location:
  • Phone: 352-509-9165
  • Fax: 352-861-7725
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number11028985
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11028985
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: