Individual
BRIDGET M. DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCS
Contact information
Practice address
2 ESSEX CENTER DR, PEABODY, MA 01960-2902
(978) 250-6240
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8051
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
160620
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036909
NEIGHBORHOOD HEALTH PLAN
MA
01
—
PN0744
BLUE CROSS
MA
Enumeration date
05/23/2006
Last updated
07/08/2007
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