Provider Demographics
NPI:1386830313
Name:FORBES, BRIDGET EDANA (RN)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:EDANA
Last Name:FORBES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2794 N BARLOW RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MI
Mailing Address - Zip Code:48742-9738
Mailing Address - Country:US
Mailing Address - Phone:989-736-8464
Mailing Address - Fax:
Practice Address - Street 1:2794 N BARLOW RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MI
Practice Address - Zip Code:48742-9738
Practice Address - Country:US
Practice Address - Phone:989-736-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704249326163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse