Individual
ALLYSON BRIDEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
222 VAIL CT, SOUTHGATE, KY 41071-2854
(505) 923-5362
(505) 620-5354
Mailing address
6400 PASEO DEL NORTE, ALBUQUERQUE, NM 87113-1718
(505) 596-2100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2023-0250
NM
Other
Enumeration date
12/12/2022
Last updated
09/19/2023
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