Provider Demographics
NPI:1477886901
Name:BRIDGES, MONICA D (CRNA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:D
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-549646163W00000X
PA082586367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1585921OtherGATEWAY
PA3749714000OtherINDEPENDENCE BLUE CROSS
PA2139034OtherFIRST PRIORITY
PA1027795480001Medicaid
PA9305461OtherAETNA
PA12003542OtherCAQH
PA2139034OtherHIGHMARK
PA129524OtherGEISINGER
PA50088429OtherCAPITAL ADVANTAGE
PA3749714000OtherINDEPENDENCE BLUE CROSS
PA172771QCYMedicare PIN