Individual provider · NPI-1

Bridget Bodenbach, PA-C

Physician Assistant · Oak Creek, WI

NPI number1669891164
StatusActive
Last updated in NPPESOct 7, 2026

Details

NPI
1669891164
Entity type
Individual (NPI-1)
Name
Ms. Bridget Bodenbach
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Apr 11, 2014
Certification date
Oct 7, 2026
Last updated
Oct 7, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant3263-23WIYes

Other names

  • Bridget Tierney (Former Name)

Practice location

200 E Ryan Rd
Oak Creek, WI 53154-4563

Phone 414-570-3590

Mailing address

Po Box 735044
Chicago, IL 60673-5044

Phone 800-326-2250

Other practice locations

9200 W Loomis Rd
Franklin, WI 53132-8887

Phone 414-529-9232 · Fax 414-529-9292

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