Organization Active NPI

Bridan Healthcare, LLC

  • Women's Health Nurse Practitioner
  • Westampton, NJ
National Provider Identifier
1154610772
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NN10281700 Issued in NJ
Legal business name
BRIDAN HEALTHCARE, LLC
Practice address
64 Bentwood Dr
Westampton, NJ 08060-5640
Phone
(609) 410-7942
Fax
(609) 871-4002
NPI assigned
Apr 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Valerie Dawn Fulton, APN/CRNP
Title
Nurse Practitioner
Phone
(609) 410-7942

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X SP010784 PA
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X 26NN10281700 NJ Primary

Addresses

Primary practice location

64 Bentwood Dr
Westampton, NJ 08060-5640

Mailing address

64 Bentwood Dr
Westampton, NJ 08060-5640
Phone (609) 410-7942

National Provider Directory

National Provider Directory

Locations

702 Main St
Unit 695
Lumberton, NJ 08048

100 Technology Way
Ste 355
Mount Laurel, NJ 08054

2001 Market St
Fl 5
Philadelphia, PA 19103
Phone (212) 894-8668

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1154610772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BENTWOOD DR",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080605640",
            "telephone_number": "609-410-7942",
            "fax_number": "609-871-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BENTWOOD DR",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080605640",
            "telephone_number": "609-410-7942",
            "fax_number": "609-871-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDAN HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "609-410-7942",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APN/CRNP"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP010784",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NN10281700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westampton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.