Provider Demographics
NPI:1235859224
Name:DOEDEN, BRIDGET
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:DOEDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6452 170TH ST
Mailing Address - Street 2:
Mailing Address - City:OCHEYEDAN
Mailing Address - State:IA
Mailing Address - Zip Code:51354-7097
Mailing Address - Country:US
Mailing Address - Phone:712-221-0729
Mailing Address - Fax:
Practice Address - Street 1:255 N WELCH AVE
Practice Address - Street 2:
Practice Address - City:PRIMGHAR
Practice Address - State:IA
Practice Address - Zip Code:51245-7765
Practice Address - Country:US
Practice Address - Phone:712-957-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA170817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily