Kathleen Rose Dunham Bridges, FNP
Individual provider Active NPI Nurse Practitioner · Lyons, GA
NPI 1033262829 · NPPES record last updated Apr 5, 2021
Key facts
- NPI
- 1033262829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN076524 (GA)
- Practice address
- 110 R T Stanley Sr Place
Lyons, GA 30436 - Phone
- (912) 526-9355
- Fax
- (912) 526-8622
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Regional Primary Care Corporation | Current | Accepting new patients |
Interoperability endpoints
- kathleen.bridges@srpcc.gadirect.net
- kathleen.bridges@hca5.eclinicaldirectplus.com
- kathleen.bridges@rts.gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN076524 | GA | |
| Nurse Practitioner | 363L00000X | RN076524 | GA | Yes |
Addresses
Primary practice location
110 R T Stanley Sr Place
Lyons, GA 30436
Mailing address
110 RT Stanley Senior PL
Lyons, GA 30436
Phone (912) 537-4986
Other providers in Lyons, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.