Provider Demographics
NPI:1629534458
Name:MIKULA, BRIDGET NICOLE (CNP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:NICOLE
Last Name:MIKULA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:NICOLE
Other - Last Name:SZELTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:527 N MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44509-1227
Mailing Address - Country:US
Mailing Address - Phone:330-797-0070
Mailing Address - Fax:
Practice Address - Street 1:320 HIGH ST NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-1222
Practice Address - Country:US
Practice Address - Phone:330-797-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.378191163W00000X
OHAPRN.CNP.024072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse