Provider Demographics
NPI:1972192029
Name:MCGREGOR, BRIDGET A (RN)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:MCGREGOR
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 1:20 LUCE AVE
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-2508
Mailing Address - Country:US
Mailing Address - Phone:401-338-9914
Mailing Address - Fax:
Practice Address - Street 1:20 LUCE AVE
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-2508
Practice Address - Country:US
Practice Address - Phone:401-338-9914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT123759163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse