Provider Demographics
NPI:1033537691
Name:BRIDGET ESPY-CRAIG
Entity Type:Organization
Organization Name:BRIDGET ESPY-CRAIG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPY-CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-917-2227
Mailing Address - Street 1:4917 STORMY RIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081
Mailing Address - Country:US
Mailing Address - Phone:702-326-0569
Mailing Address - Fax:
Practice Address - Street 1:833 ASPEN PEAK LOOP
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1803
Practice Address - Country:US
Practice Address - Phone:702-326-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIDGET ESPY-CRAIG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization