Healthcare Provider Details

I. General information

NPI: 1366930331
Provider Name (Legal Business Name): BRIDGET C THORNE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIDGET C WHITFIELD RN

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RONALD REAGAN PKWY
AVON IN
46123-7085
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-217-3500
  • Fax: 317-217-3551
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71007933A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: