Provider Demographics
NPI:1013418078
Name:BRIDGES, DARLA (CRT)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:DARLA
Other - Middle Name:
Other - Last Name:WASKOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:70444-0865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16874 HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:LA
Practice Address - Zip Code:70441-4834
Practice Address - Country:US
Practice Address - Phone:225-222-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACRT.LT3010227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified