Individual
BRIDGET KATHLEEN DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
52 SECOND AVE STE 2600, WALTHAM, MA 02451-1129
(781) 487-3838
Mailing address
52 SECOND AVE STE 2600, WALTHAM, MA 02451-1129
(781) 487-3838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2316524
MA
363L00000X
Nurse Practitioner
Primary
RN2316524
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110202362A
MASSHEALTH
MA
Enumeration date
11/16/2020
Last updated
02/06/2024
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