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MRS. BRIDGET ODONNELL GEORGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
1321 MCARTHUR ST, MANCHESTER, TN 37355-2425
(931) 728-0772
(931) 728-0444
Mailing address
311 KINGS RIDGE, TULLAHOMA, TN 37388-0000
(931) 454-9863

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5896
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3709474
TN
01
4048794
BLUE CROSS BLUE SHIELD
TN
01
5896
APN
TN
01
DA2686
RAILROAD MEDICARE
TN
Enumeration date
04/25/2006
Last updated
12/29/2009
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