Individual
BRIDGET ANN PENDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
22463 FENTON DEDEAUX RD, KILN, MS 39556-6578
(228) 586-6846
Mailing address
22463 FENTON DEDEAUX RD, KILN, MS 39556-6578
(228) 586-6846
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P322364
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2297121
—
OH
Enumeration date
01/23/2008
Last updated
01/23/2008
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