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NPI Code Detail

MEDICARE: BRENDA K BRIDGES CNM

MEDICARE: BRENDA K BRIDGES CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife117779WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710938816
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA K BRIDGES CNM
Provider Business Mailing Address
First Line : 1333 IRIS AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-2226
Country : US
Telephone Number : 303-443-8500
Fax Number : 303-413-6325
Provider Business Practice Location Address
First Line : 1333 IRIS AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-2226
Country : US
Telephone Number : 303-443-8500
Fax Number : 303-413-6325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 08/31/2016

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Directions to “ BRENDA K BRIDGES CNM” Practice Location

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