Basic Information
| Provider Information | |||||||||
| NPI: | 1144688102 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSS-FITZGIBBONS | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APRN, AGNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 CHURCH HILL RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | LEEDS | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042633418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075243501 | ||||||||
| FaxNumber: | 2075242093 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | BRIDGTON | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040091167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075243501 | ||||||||
| FaxNumber: | 2076474000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2016 | ||||||||
| LastUpdateDate: | 11/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 074640-23 | NH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LG0600X | 074640-23 | NH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363L00000X | CNP211325 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.