Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 45449 | KS |
NPI | 1942262274 |
---|---|
Provider Name | Lynn A Bridge |
First Address | Emporia, KS 66801-5367 |
Second Address | Emporia, KS 66801-5367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 08/07/2007 |