Provider Demographics
NPI:1912561150
Name:BRIDGES, KRISTA (RN)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 KAMEHAME DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-2859
Mailing Address - Country:US
Mailing Address - Phone:808-777-9808
Mailing Address - Fax:
Practice Address - Street 1:1028 KAMEHAME DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-2859
Practice Address - Country:US
Practice Address - Phone:808-777-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI25071163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool