Healthcare Provider Details

I. General information

NPI: 1821079294
Provider Name (Legal Business Name): BRIDGETTE ANNE OSTMEYER O.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 NW HUNTERS RIDGE CIR STE B
TOPEKA KS
66618-2538
US

IV. Provider business mailing address

2800 SW WANAMAKER RD SUITE 192
TOPEKA KS
66614-4293
US

V. Phone/Fax

Practice location:
  • Phone: 785-246-3937
  • Fax: 785-246-0527
Mailing address:
  • Phone: 785-272-0707
  • Fax: 785-271-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberKS-1490-3
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: