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Individual

BRIDGET COLETTE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1313 N MAIN ST, BEAVER DAM, KY 42320-8957
(270) 274-9928
(270) 274-0134
Mailing address
PO BOX 148, HARTFORD, KY 42347-0148
(270) 504-1300
(270) 504-1980

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004698P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000384686
BCBS PROVIDER NUMBER
01
4698P
LICENSE
KY
05
78015393
KY
Enumeration date
09/17/2006
Last updated
11/22/2022
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