Provider Demographics
NPI:1306099528
Name:BRIDGES, ANGELIA JAN (RN BSN MPH)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:JAN
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RN BSN MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 GREAT WEST LOOP
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-9243
Mailing Address - Country:US
Mailing Address - Phone:254-780-9973
Mailing Address - Fax:
Practice Address - Street 1:74 GREAT WEST LOOP
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-9243
Practice Address - Country:US
Practice Address - Phone:254-780-9973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666484163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health