Provider Demographics
NPI:1467998971
Name:HODGES, BRIDGET BERTRAND (FNP-C, APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:BERTRAND
Last Name:HODGES
Suffix:
Gender:F
Credentials:FNP-C, APRN
Other - Prefix:MISS
Other - First Name:BRIDGET
Other - Middle Name:ANNA
Other - Last Name:BERTRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7777 BLUEBONNET BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1632
Mailing Address - Country:US
Mailing Address - Phone:225-766-9091
Mailing Address - Fax:225-766-9317
Practice Address - Street 1:54002 HIGHWAY 1062
Practice Address - Street 2:
Practice Address - City:LORANGER
Practice Address - State:LA
Practice Address - Zip Code:70446-3538
Practice Address - Country:US
Practice Address - Phone:225-683-5292
Practice Address - Fax:225-683-1310
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2436066Medicaid