Provider Demographics
NPI:1316974256
Name:KELLY, BRIDGET LYNELL (RN)
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:LYNELL
Last Name:KELLY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:CARL R DARNALL ARMY MEDICAL CENTER
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31ST AND BATTALLION
Practice Address - Street 2:BLDG 420
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-618-8040
Practice Address - Fax:254-618-8099
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX716837163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care