Provider Demographics
NPI:1689342404
Name:BRIDGE TO HEALTH, P.A.
Entity Type:Organization
Organization Name:BRIDGE TO HEALTH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DEBELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:218-282-4925
Mailing Address - Street 1:1817 HIGHWAY 53
Mailing Address - Street 2:
Mailing Address - City:COOK
Mailing Address - State:MN
Mailing Address - Zip Code:55723-8173
Mailing Address - Country:US
Mailing Address - Phone:218-282-4925
Mailing Address - Fax:218-506-9635
Practice Address - Street 1:1817 HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:COOK
Practice Address - State:MN
Practice Address - Zip Code:55723-8173
Practice Address - Country:US
Practice Address - Phone:218-208-7502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-06
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care