Provider Demographics
NPI:1174906937
Name:HILL, BRIDGETTE
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 S COOPER ST
Mailing Address - Street 2:SUITE 103-972
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3446
Mailing Address - Country:US
Mailing Address - Phone:469-231-4935
Mailing Address - Fax:
Practice Address - Street 1:3415 S COOPER ST
Practice Address - Street 2:SUITE 103-972
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3446
Practice Address - Country:US
Practice Address - Phone:469-231-4935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10-3504164X00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide