Individual
JACQUALINE BRIDGEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4484
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4484
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28126078A
IN
Other
Enumeration date
12/21/2015
Last updated
06/06/2016
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