Provider Demographics
NPI:1619275153
Name:BRIDGES, BEVERLY SUE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:SUE
Last Name:BRIDGES
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 1:1 W LAKESHORE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7271
Mailing Address - Country:US
Mailing Address - Phone:205-408-4134
Mailing Address - Fax:205-408-1229
Practice Address - Street 1:4600 HIGHWAY 280 S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5028
Practice Address - Country:US
Practice Address - Phone:205-408-4134
Practice Address - Fax:205-408-1229
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-117729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily