MEDICARE: MISS CHRISTIAN BRIDGES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	327269	NY

General Provider Information

NPI Number	:	1356893184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHRISTIAN BRIDGES

Provider Business Mailing Address
First Line	:	1504 SAINT PAUL ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3130
Country	:	US
Telephone Number	:	585-278-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 SAINT PAUL ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3130
Country	:	US
Telephone Number	:	585-278-3786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	10/27/2016

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Directions to “ MISS CHRISTIAN BRIDGES ” Practice Location

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