Provider Demographics
NPI:1912744509
Name:CAMPBELL, BRIDGETTE (FNP-C)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2014
Mailing Address - Country:US
Mailing Address - Phone:337-482-1000
Mailing Address - Fax:
Practice Address - Street 1:104 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2014
Practice Address - Country:US
Practice Address - Phone:337-482-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9908332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily