Provider Demographics
NPI:1215567995
Name:O'LEARY, BRIDGET CATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:CATHERINE
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10719 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2487
Mailing Address - Country:US
Mailing Address - Phone:517-366-9826
Mailing Address - Fax:
Practice Address - Street 1:105 MCNEIL ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3345
Practice Address - Country:US
Practice Address - Phone:501-315-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant