Provider Demographics
NPI:1467116699
Name:BLUE, BRIDGET MARCIA FAITH (NP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MARCIA FAITH
Last Name:BLUE
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 1:24 INDEPENDENT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744-1806
Mailing Address - Country:US
Mailing Address - Phone:508-317-9088
Mailing Address - Fax:
Practice Address - Street 1:277 PLEASANT ST STE 306
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-675-3232
Practice Address - Fax:508-675-4942
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMCS009376B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner