Healthcare Provider Details
I. General information
NPI: 1548065899
Provider Name (Legal Business Name): BRIDGES BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
330 OLD STEESE HWY
FAIRBANKS AK
99701-3126
US
IV. Provider business mailing address
330 OLD STEESE HWY
FAIRBANKS AK
99701-3126
US
V. Phone/Fax
- Phone: 720-569-0848
- Fax:
- Phone: 907-416-3993
- Fax: 907-931-6100
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JENNIFER
L
NAYLOR
Title or Position: OWNER/PROVIDER
Credential:
Phone: 907-416-3993