Provider Demographics
NPI:1568161503
Name:BAINBRIDGE, BOBBI (LPN)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:
Last Name:BAINBRIDGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 E ISABELLA RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-8344
Mailing Address - Country:US
Mailing Address - Phone:989-513-3447
Mailing Address - Fax:
Practice Address - Street 1:1213 E ISABELLA RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-8344
Practice Address - Country:US
Practice Address - Phone:989-513-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703090434164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse