Healthcare Provider Details

I. General information

NPI: 1265124192
Provider Name (Legal Business Name): BRIDGET HERRING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2470 STANTONSBURG RD
GREENVILLE NC
27834-7210
US

IV. Provider business mailing address

2516 ELLA BELL RUN
WINTERVILLE NC
28590-2305
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-3000
  • Fax:
Mailing address:
  • Phone: 703-638-3701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberHERR-TXYEO
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5018131
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: