Provider Demographics
NPI:1619417094
Name:HANNIGAN, BRIDGETTE (RCS)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:HANNIGAN
Suffix:
Gender:F
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 RAMBLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-2162
Mailing Address - Country:US
Mailing Address - Phone:678-755-5334
Mailing Address - Fax:
Practice Address - Street 1:2539 RAMBLEWOOD CT
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-2162
Practice Address - Country:US
Practice Address - Phone:678-755-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography