Provider Demographics
NPI:1225522733
Name:KILBRIDE, BRIDGET M (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:KILBRIDE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:109 WARREN ST STE 1
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-3082
Practice Address - Country:US
Practice Address - Phone:920-885-2622
Practice Address - Fax:920-885-4419
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2024-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI4415-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant