PATRICIA ANN BRIDEWELL


Address: 5245 Concourse Drive, Suite 100, Los Angeles, CA 90045
Phone: 3106622000

PATRICIA ANN BRIDEWELL (NPI# 1386171585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386171585
Entity Type Individual
Full Name PATRICIA ANN BRIDEWELL
Credential NURSE PRACTITIONER
Practice Address 5245 Concourse Drive
Suite 100
Los Angeles
CA 90045
Mailing Address 14530 Lemoli Ave Apt 10
Hawthorne
CA 90250-9017
Practice Telephone 3106622000
Mailing Telephone 3233650290
Enumeration Date 2017-05-18
Last Update Date 2017-11-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 536499 CA Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
95005599 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 5245 CONCOURSE DRIVE
SUITE 100
City LOS ANGELES
State CA
Zip Code 90045

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90045

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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