Provider Demographics
NPI:1194882936
Name:BRIDGES, MEGAN M (CNM)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-6005
Mailing Address - Fax:612-630-8242
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2203
Practice Address - Fax:612-904-4273
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN12230367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN065475000Medicaid
MN135833OtherUCARE
MN918N3BROtherBLUE CROSS BLUE SHIELD
MN065475000Medicaid