Healthcare Provider Details

I. General information

NPI: 1013985167
Provider Name (Legal Business Name): BRIDGET BELO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 N CLEVELAND AVE STE 100
WESTERVILLE OH
43082-9845
US

IV. Provider business mailing address

6710 WYNWRIGHT DR
DUBLIN OH
43016-9305
US

V. Phone/Fax

Practice location:
  • Phone: 614-895-3333
  • Fax:
Mailing address:
  • Phone: 614-530-2818
  • Fax: 614-722-4203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.06884-NA
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number66697
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: