Provider Demographics
NPI:1225499635
Name:CROSS, BRIDGETTE (CPNP)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 TULLIE RD NE FL 1
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2309
Mailing Address - Country:US
Mailing Address - Phone:404-785-8787
Mailing Address - Fax:404-785-8788
Practice Address - Street 1:1400 TULLIE RD NE FL 1
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2309
Practice Address - Country:US
Practice Address - Phone:404-785-8787
Practice Address - Fax:404-785-8788
Is Sole Proprietor?:No
Enumeration Date:2016-03-11
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN263202363L00000X
NC5014436363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics