Provider Demographics
NPI:1114779469
Name:NELSON, BRIDGETT COURTOIS (MD)
Entity type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:COURTOIS
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIDGETT
Other - Middle Name:FEE
Other - Last Name:COURTOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD # MS 1034
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-3304
Mailing Address - Fax:913-588-3365
Practice Address - Street 1:3901 RAINBOW BLVD # MS 1034
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-3304
Practice Address - Fax:913-588-3365
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS94-11819207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program