Provider Demographics
NPI:1851048284
Name:JABLONSKI, BRIDGET (RN)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:JABLONSKI
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 1:29455 N. CAVE CREEK RD. STE 118 # 470
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331
Mailing Address - Country:US
Mailing Address - Phone:480-877-0037
Mailing Address - Fax:855-930-1406
Practice Address - Street 1:6020 E CALLE DE POMPAS
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-2509
Practice Address - Country:US
Practice Address - Phone:480-877-0037
Practice Address - Fax:855-930-1406
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-05
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
AZRN104191163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator