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Individual

LANA BRIDGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215-1161
(502) 367-3360
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 367-3360

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC005
KY
363AM0700X
Medical Physician Assistant
10002563A
IN

Other

Enumeration date
05/01/2018
Last updated
11/03/2021
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