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General NPI Number Information
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NPI Number | 1902612989
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Entity Type | Individual
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Provider Name | BRIDGET HENRY PMHMP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 2230 VENETIAN CT STE 1
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City | NAPLES
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State | FL
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Zip | 34109-8727
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Country | US
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Telephone | 239-690-6906
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Fax |
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Provider Business Mailing Address
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Address Line | 3752 COSTA MAYA WAY
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City | ESTERO
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State | FL
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Zip | 33928-2129
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Country | US
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Telephone | 773-547-9411
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11036776
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | RN9452806
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License Number State | FL
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