Individual
MRS. KIM MICHELLE BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSNA
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2211
Mailing address
14721 STEPHENSON RD, MORNING VIEW, KY 41063-9641
(859) 356-2716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1093910
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
086672
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000691770
ANTHEM
—
05
—
201006220
—
IN
05
—
3120830
—
OH
01
—
611077369 1295716850
HEALTHNET
—
05
—
7100146110
—
KY
Enumeration date
11/17/2010
Last updated
06/13/2012
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