Provider Demographics
NPI:1356890735
Name:BRIDGET'S SURGICAL FIRST ASSIST
Entity type:Organization
Organization Name:BRIDGET'S SURGICAL FIRST ASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-945-7281
Mailing Address - Street 1:1815 CENTRAL PARK DR
Mailing Address - Street 2:STE 110 PMB 231
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8885
Mailing Address - Country:US
Mailing Address - Phone:610-945-7281
Mailing Address - Fax:
Practice Address - Street 1:1815 CENTRAL PARK DR
Practice Address - Street 2:STE 110 PMB 231
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8885
Practice Address - Country:US
Practice Address - Phone:610-945-7281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0992518163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty