Provider Demographics
NPI:1851145601
Name:BRIDGFORD, DENA KATHERINE (RN)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:KATHERINE
Last Name:BRIDGFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:KATHERINE
Other - Last Name:LESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:459 PATTERSON RD OFC
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1522
Mailing Address - Country:US
Mailing Address - Phone:808-566-8380
Mailing Address - Fax:
Practice Address - Street 1:459 PATTERSON RD OFC
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:808-566-8380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA099106163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse