Healthcare Provider Details

I. General information

NPI: 1245707546
Provider Name (Legal Business Name): BROOKE NICOLE BRIDGES PHARMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-9290
US

IV. Provider business mailing address

1000 S LIMESTONE ROOM H112
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-4267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number021673
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26027982A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03337509
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: