Provider Demographics
NPI:1689957607
Name:YEBOAH-SPAUN, BRIDGETTE NIPAA (NP)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:NIPAA
Last Name:YEBOAH-SPAUN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRIDGETTE
Other - Middle Name:NIPAA
Other - Last Name:YEBOAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1902
Mailing Address - Country:US
Mailing Address - Phone:508-384-5567
Mailing Address - Fax:508-384-8938
Practice Address - Street 1:131 EMERALD ST
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1902
Practice Address - Country:US
Practice Address - Phone:508-384-5567
Practice Address - Fax:508-384-8938
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991261-NP363LF0000X
MARN 283358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily