Provider Demographics
NPI:1679913503
Name:MEDUNA, BRIDGET A (OD)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:MEDUNA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 N 66TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2478
Mailing Address - Country:US
Mailing Address - Phone:402-464-3156
Mailing Address - Fax:402-464-3156
Practice Address - Street 1:651 N 66TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2478
Practice Address - Country:US
Practice Address - Phone:402-464-3156
Practice Address - Fax:402-464-3156
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1391152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist