Provider Demographics
NPI:1609466150
Name:APPELFELLER, BRIDGET MARIE
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MARIE
Last Name:APPELFELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11755 STATE ROUTE 47
Mailing Address - Street 2:
Mailing Address - City:WEST MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43358-9512
Mailing Address - Country:US
Mailing Address - Phone:937-209-1377
Mailing Address - Fax:
Practice Address - Street 1:11755 STATE ROUTE 47
Practice Address - Street 2:
Practice Address - City:WEST MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43358-9512
Practice Address - Country:US
Practice Address - Phone:937-209-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH80029133747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant