Kistner, Bridget Lynn

Kistner, Bridget Lynn is an individual health care provider with primary practice located at 1025 S 6Th St , Springfield IL 62703-2499. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Nuclear Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Kistner, Bridget Lynn can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
1025 S 6Th St Springfield IL 62703-2499
Phone: (217) 528-7541
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036162130 Illinois
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2020011852 Missouri
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X 036162130 Illinois

Profile Details

NPI number 1649652728
LBN Legal business name Kistner, Bridget Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2015
Last updated Feb 6th, 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 1649652728 NPPES
Missouri MEDICAID 200083831

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