Provider Demographics
NPI:1740370790
Name:NAJERA, DEANNA LYNN BRIDGE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:LYNN BRIDGE
Last Name:NAJERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5219
Mailing Address - Country:US
Mailing Address - Phone:410-876-4949
Mailing Address - Fax:410-876-4959
Practice Address - Street 1:290 S CENTER ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5219
Practice Address - Country:US
Practice Address - Phone:410-876-4930
Practice Address - Fax:410-876-4959
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC04398363A00000X
VA0110-008348363A00000X
DCPA200001322363A00000X
PAMA052725363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120420417OtherDEPT OF LABOR
PA25-1716306OtherHEALTHNET/TRICARE
PAMA052725OtherPA LICENSE
PAOA002535OtherOSTEOPATHIC LICENSE NUMBER
PA25-1716306OtherINTERGROUP
PA25-1716306OtherDEVON
MDPA71213OtherCDS LICENSE NUMBER
MD945LOtherMEDICARE GROUP NUMBER
MDC04398OtherMARYLAND STATE LICENSE
MDC04398OtherMARYLAND STATE LICENSE
MDC04398OtherMARYLAND STATE LICENSE
MDPA71213OtherCDS LICENSE NUMBER
PA25-1716306OtherHEALTHNET/TRICARE
PAQ78112Medicare UPIN
PAOA002535OtherOSTEOPATHIC LICENSE NUMBER