Provider Demographics
NPI:1821044454
Name:CAHILL, BRIDGET (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:
Last Name:CAHILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39441-0247
Mailing Address - Country:US
Mailing Address - Phone:601-477-2226
Mailing Address - Fax:601-477-2236
Practice Address - Street 1:1203 AVE B
Practice Address - Street 2:STE 300
Practice Address - City:ELLISVILLE
Practice Address - State:MS
Practice Address - Zip Code:39437-2080
Practice Address - Country:US
Practice Address - Phone:601-477-2226
Practice Address - Fax:601-477-2236
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR857079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01703544Medicaid
358072YZY3Medicare PIN
MS01703544Medicaid