Healthcare Provider Details

I. General information

NPI: 1275386856
Provider Name (Legal Business Name): BRIDGETTE N. ROWLEY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIDGETTE N. PARR

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3403
US

IV. Provider business mailing address

9 E CRESCENT AVE
NEWPORT KY
41071-2516
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-2421
  • Fax:
Mailing address:
  • Phone: 859-653-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number0036258
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number508812
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: