Individual
MR. PATRICK TIMOTHY BRINGARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4588
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4588
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201606922NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
NORTH BEND MEDICAL CENTER GROUP NPI
OR
01
—
161133
NORTH BEND MEDICAL CENTER GROUP MEDICAID
OR
05
—
500713885
—
OR
01
—
93-0635514
NORTH BEND MEDICAL CENTER GROUP TAX ID
OR
01
—
P01716857
RAILROAD MEDICARE
OR
01
—
R0000WFBTV
NORTH BEND MEDICAL CENTER GROUP MEDICARE
OR
Enumeration date
08/30/2016
Last updated
10/31/2016
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