Provider Demographics
NPI:1366889412
Name:BRIDGES, MELISSA Z (CRNA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:Z
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MERIDIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6325
Mailing Address - Country:US
Mailing Address - Phone:615-465-3234
Mailing Address - Fax:615-465-2955
Practice Address - Street 1:400 N EDWARDS ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2510
Practice Address - Country:US
Practice Address - Phone:334-347-0584
Practice Address - Fax:334-347-2080
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138462367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered