Provider Demographics
NPI:1811887227
Name:BRIDGES, CHRISTY RENEE (LMBT, RN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:RENEE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:LMBT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 GLEN COVE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-7445
Mailing Address - Country:US
Mailing Address - Phone:704-956-9686
Mailing Address - Fax:
Practice Address - Street 1:5041 GLEN COVE DR
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-7445
Practice Address - Country:US
Practice Address - Phone:704-956-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1312225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist