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NPI Code Detail

MEDICARE: MS. JANE ELLEN BRIDGES ANP-C

MEDICARE:  MS. JANE ELLEN BRIDGES  ANP-C
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
1363LA2200XAdult Health Nurse PractitionerRN127822AZ

General Provider Information

NPI Number : 1366403248
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANE ELLEN BRIDGES ANP-C
Provider Business Mailing Address
First Line : 3080 ADOBE SPRINGS DR
Second Line :
City : PRESCOTT
State : AZ
Zip : 86301-6664
Country : US
Telephone Number : 928-717-0882
Fax Number :
Provider Business Practice Location Address
First Line : 804 AINSWORTH DR
Second Line : SUITE 104
City : PRESCOTT
State : AZ
Zip : 86301-1624
Country : US
Telephone Number : 928-778-1736
Fax Number : 928-717-0785
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2006
Last Update Date : 07/08/2007

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Directions to “ MS. JANE ELLEN BRIDGES ANP-C” Practice Location

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