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Kelly Bridges Neurosurgery PLLC

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Company Details

Name: Kelly Bridges Neurosurgery PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Aug 2019 (6 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 3597853
Place of Formation: IDAHO
File Number: 677475
ZIP code: 83704
County: Ada County
Principal Address: KELLY BRIDGES STE 400 6140 W CURTISIAN AVE BOISE, ID 83704
Mailing Address: KELLY BRIDGES STE 400 6140 W CURTISIAN AVE BOISE, ID 83704-8907

Agent

Name Role Address
Paul M Broadbent Agent 12550 W EXPLORER DR, STE 200, BOISE, ID 83713-1890

Member

Name Role Address Appointed On
Kelly Bridges Member 6140 W CURTISIAN AVENUE, BOISE, ID 83704 2020-07-03

National Provider Identifier

NPI Number:
1851949713
Certification Date:
2022-05-09

Authorized Person:

Name:
KELLY J BRIDGES
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207T00000X - Neurological Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
2083275602

Filing

Filing Name Filing Number Filing date
Annual Report 0005842537 2024-08-05
Annual Report 0005303193 2023-07-05
Annual Report 0004806042 2022-07-06
Change of Registered Office/Agent/Both (by Entity) 0004718860 2022-05-10
Annual Report 0004332394 2021-07-05

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Date of last update: 17 May 2025

Sources: Idaho Secretary of State