1396853859 NPI number — BRIDGET RENEE TERWILLIGER CNM

Table of content: BRIDGET RENEE TERWILLIGER CNM (NPI 1396853859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396853859 NPI number — BRIDGET RENEE TERWILLIGER CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TERWILLIGER
Provider First Name:
BRIDGET
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRANDT/PIERCE
Provider Other First Name:
BRIDGET
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396853859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36065 SANTA FE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT HOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76544-5060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-288-8109
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CRDAMC
Provider Second Line Business Practice Location Address:
590 MEDICAL CENTER ROAD
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544-5060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-288-8109
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  AP126321 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: AP126321 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)