Provider Demographics
NPI:1720743123
Name:JENNINGS, BRIDGET EARLE (PA-C)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:EARLE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4500 8TH DIVISION RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29207-5700
Mailing Address - Country:US
Mailing Address - Phone:803-751-2273
Mailing Address - Fax:803-751-2884
Practice Address - Street 1:4500 8TH DIVISION RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29207-5700
Practice Address - Country:US
Practice Address - Phone:803-751-2273
Practice Address - Fax:803-751-2884
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2025-08-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant