Individual
JAMIE BRIDGWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
233 BEACON PL APT 2, MUNSTER, IN 46321-1101
(708) 539-6234
Mailing address
233 BEACON PL APT 2, MUNSTER, IN 46321-1101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28178901A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28178901A
IN
Other
Enumeration date
12/07/2017
Last updated
01/11/2018
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