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NPI Code Detail

MEDICARE: BRIDGET RUDOLPH ROSCOE

MEDICARE:   BRIDGET RUDOLPH ROSCOE
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1-127564AL

General Provider Information

NPI Number : 1750750519
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET RUDOLPH ROSCOE
Provider Business Mailing Address
First Line : 2090 COLUMBIANA RD
Second Line : STE 4000
City : VESTAVIA
State : AL
Zip : 35216-2153
Country : US
Telephone Number : 205-536-8400
Fax Number :
Provider Business Practice Location Address
First Line : 2090 COLUMBIANA RD
Second Line : STE 4000
City : VESTAVIA
State : AL
Zip : 35216-2153
Country : US
Telephone Number : 205-536-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2015
Last Update Date : 09/22/2015

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Directions to “ BRIDGET RUDOLPH ROSCOE ” Practice Location

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