Provider Demographics
NPI:1427045384
Name:SMITH, BRIDGETTE OLINGER (NP)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:OLINGER
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24263-1215
Mailing Address - Country:US
Mailing Address - Phone:276-546-5310
Mailing Address - Fax:276-546-5469
Practice Address - Street 1:306 S SHADY AVE
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:VA
Practice Address - Zip Code:24236
Practice Address - Country:US
Practice Address - Phone:276-475-5116
Practice Address - Fax:276-475-5665
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024062362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3345320Medicaid
TN3345320Medicare PIN
TN3345320Medicaid