Healthcare Provider Details
I. General information
NPI: 1912254715
Provider Name (Legal Business Name): BRIDGET ROSE JOREITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2012
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8775 NORWIN AVE STE D
IRWIN PA
15642-2718
US
IV. Provider business mailing address
8775 NORWIN AVE STE D
IRWIN PA
15642-2718
US
V. Phone/Fax
- Phone: 724-863-2660
- Fax: 724-863-2668
- Phone: 724-863-2660
- Fax: 724-863-2668
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP012257 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: