Doctor Name: | KATHLEEN R DUNHAM-BRIDGES |
NPI Number: | 1033262829 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | RN076524 |
Business Practice Address: | 110 R T Stanley Sr Place Lyons, GA - 30436 |
Business Phone Number: | 9125269355 |
Business Fax Number: | 9125268622 |
Mailing Address: | Po Box 407, VIDALIA |
State: | GA |
Postal Code: | 304750407 |
Phone Number: | 9125374986 |
Fax Number: | |
NPI Enumeration Date: | 01/18/2007 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN076524 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |