Individual
BRIDGETTE A HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6494 NW GROVELAND TER, PORT ST LUCIE, FL 34986-3825
(561) 644-4283
Mailing address
6494 NW GROVELAND TER, PORT ST LUCIE, FL 34986-3825
(561) 644-4283
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1068941
FL
251G00000X
Community Based Hospice Care Agency
PN1068941
FL
343900000X
Non-emergency Medical Transport (VAN)
PN1068941
FL
347C00000X
Private Vehicle
PN1068941
FL
Other
Enumeration date
03/30/2007
Last updated
06/11/2012
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