Provider Demographics
NPI:1912559980
Name:BUFFINGTON, BRIDGETT DANIELLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:DANIELLE
Last Name:BUFFINGTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 W BALDWIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3359
Mailing Address - Country:US
Mailing Address - Phone:850-769-0329
Mailing Address - Fax:844-212-7396
Practice Address - Street 1:625 W BALDWIN RD STE C
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3359
Practice Address - Country:US
Practice Address - Phone:850-769-0329
Practice Address - Fax:844-212-7396
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009774363L00000X
GARN231326363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner