Provider Demographics
NPI:1386351625
Name:EARLS, BRIDGETTE MARIE (RN)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:MARIE
Last Name:EARLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ARDEN LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3543
Mailing Address - Country:US
Mailing Address - Phone:501-358-9322
Mailing Address - Fax:
Practice Address - Street 1:1600 ARDEN LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3543
Practice Address - Country:US
Practice Address - Phone:501-358-9322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR062788163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health