Provider Demographics
NPI:1891942843
Name:WILLIAMS, BRIDGET ALICIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:ALICIA
Last Name:WILLIAMS
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 1:180 HOOKER AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3306
Mailing Address - Country:US
Mailing Address - Phone:845-485-5636
Mailing Address - Fax:845-473-6692
Practice Address - Street 1:180 HOOKER AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3306
Practice Address - Country:US
Practice Address - Phone:845-485-5636
Practice Address - Fax:845-473-6692
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263942-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse