Provider Demographics
NPI:1285129767
Name:WILLIAMS-COOPER, BRIDGETT EVETTE (ARNP)
Entity type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:EVETTE
Last Name:WILLIAMS-COOPER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 FIDDLELEAF CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8151
Mailing Address - Country:US
Mailing Address - Phone:321-261-7943
Mailing Address - Fax:321-522-4500
Practice Address - Street 1:6300 N WICKHAM RD STE 130-420
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2028
Practice Address - Country:US
Practice Address - Phone:321-261-7943
Practice Address - Fax:321-522-4500
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023539363LF0000X
FLRN9323732163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse