Provider Demographics
NPI:1285412643
Name:BRIDGES, RACHEL TUCKER (LPN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:TUCKER
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:RENEE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:146 ATHENS RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-5750
Mailing Address - Country:US
Mailing Address - Phone:865-910-1286
Mailing Address - Fax:
Practice Address - Street 1:146 ATHENS RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-5750
Practice Address - Country:US
Practice Address - Phone:865-910-1286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000087947164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse