Provider Demographics
NPI:1821303280
Name:GREEN, BRIDGET LEIGH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:LEIGH
Last Name:GREEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-5020
Mailing Address - Country:US
Mailing Address - Phone:303-233-1855
Mailing Address - Fax:
Practice Address - Street 1:550 E THORNTON PKWY
Practice Address - Street 2:SUITE 240-C
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2100
Practice Address - Country:US
Practice Address - Phone:303-327-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPN 45845164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse