Gordy, Bridget Nicole Green

Gordy, Bridget Nicole Green is an individual health care provider with primary practice located at 802 Dixie St , Carrollton GA 30117-4416. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gordy, Bridget Nicole Green can be contacted via phone (770) 836-9445.

Contact Information

Primary practice address
802 Dixie St Carrollton GA 30117-4416
Phone: (770) 836-9445
Fax: (770) 836-9353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN231607 Georgia

Profile Details

NPI number 1265755110
LBN Legal business name Gordy, Bridget Nicole Green
Credentials FNP , RN
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2010
Last updated Apr 3rd, 2014 - about 11 years ago

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 1265755110 NPPES
Tennessee MEDICAID 1517993

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