Bridgman, Kelli Nicole

Bridgman, Kelli Nicole is an sole proprietor health care provider with primary practice located at 804 Dunlawton Ave Ste 1 , Port Orange FL 32127-4931. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Bridgman, Kelli Nicole can be contacted via phone (386) 767-8584.

Contact Information

Primary practice address
804 Dunlawton Ave Ste 1 Port Orange FL 32127-4931
Phone: (386) 767-8584
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN164274 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ME73316 Florida

Profile Details

NPI number 1588841977
LBN Legal business name Bridgman, Kelli Nicole
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 28th, 2008
Last updated Mar 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588841977 NPPES
Georgia MEDICAID 448879182A

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