Provider Demographics
NPI:1609422351
Name:FOX, BRIDGET COLLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:COLLEEN
Last Name:FOX
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1479
Mailing Address - Country:US
Mailing Address - Phone:570-877-7386
Mailing Address - Fax:
Practice Address - Street 1:521 MT PLEASANT DR STE 101
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1993
Practice Address - Country:US
Practice Address - Phone:570-346-7338
Practice Address - Fax:570-341-3025
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020658363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily