Individual
NICOLE LYNN BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
14617 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-1416
(503) 962-1782
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201390924NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500660850
—
OR
Enumeration date
07/30/2013
Last updated
09/18/2020
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