Provider Demographics
NPI:1942584503
Name:NUGENT, BRIDGET DENISE (FNP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:DENISE
Last Name:NUGENT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SHADY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-2570
Mailing Address - Country:US
Mailing Address - Phone:318-452-1767
Mailing Address - Fax:
Practice Address - Street 1:6675 BUSINESS PKWY STE F
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6349
Practice Address - Country:US
Practice Address - Phone:318-452-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN040508-AP06603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily