Provider Demographics
NPI:1326524786
Name:BRIDGEMAN, LESMEEK (RN)
Entity Type:Individual
Prefix:
First Name:LESMEEK
Middle Name:
Last Name:BRIDGEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LESMEEK
Other - Middle Name:
Other - Last Name:ROUNDTREE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:41521 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1803
Mailing Address - Country:US
Mailing Address - Phone:248-299-0030
Mailing Address - Fax:248-655-7959
Practice Address - Street 1:41521 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1803
Practice Address - Country:US
Practice Address - Phone:248-299-0030
Practice Address - Fax:248-655-7959
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703118192164W00000X
MI4704382399163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse