Individual
CORINA BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 ROCKINGHAM LN, LOGANVILLE, GA 30052-8743
(678) 477-1274
Mailing address
504 ROCKINGHAM LN, LOGANVILLE, GA 30052-8743
(678) 477-1274
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN259844
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/04/2020
Last updated
11/04/2020
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