Provider Demographics
NPI:1881138840
Name:HARP, BRIDGETTE (FNP)
Entity type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:
Last Name:HARP
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 1:9303 N 7TH ST
Mailing Address - Street 2:UNIT 4
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2531
Mailing Address - Country:US
Mailing Address - Phone:602-305-5100
Mailing Address - Fax:
Practice Address - Street 1:19646 N 27TH AVE STE 403
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4028
Practice Address - Country:US
Practice Address - Phone:623-879-4477
Practice Address - Fax:623-879-4445
Is Sole Proprietor?:No
Enumeration Date:2016-12-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ298526Medicaid