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General NPI Number Information
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NPI Number | 1780298562
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Entity Type | Individual
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Provider Name | BRIDGET PEURACH AGNP-C, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 215 S US HIGHWAY 17
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City | EAST PALATKA
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State | FL
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Zip | 32131-4087
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Country | US
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Telephone | 386-232-9203
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Fax | 386-222-3064
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Provider Business Mailing Address
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Address Line | 209 PINEHURST POINTE DR
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3703
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Country | US
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Telephone | 386-232-9203
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Fax | 386-222-3064
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11035825
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License Number State | FL
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