Individual
MRS. TRINIDAD BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2909 S. 10TH AVENUE, CALDWELL, ID 83605
(208) 454-2766
Mailing address
PO BOX 245, KUNA, ID 83634-0245
(208) 859-6473
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-8693
ID
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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