Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP126943 | TX |
NPI | 1013314459 |
---|---|
Provider Name | Bobbi Bridges |
First Address | San Antonio, TX 78216-6235 |
Second Address | San Antonio, TX 78216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2014 |
Last Update Date | 01/12/2014 |