Healthcare Provider Details

I. General information

NPI: 1407646771
Provider Name (Legal Business Name): BRIDGECARE HEALTH NAVIGATORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6135 CLINTON TINNIN RD
JACKSON MS
39209-9121
US

IV. Provider business mailing address

6135 CLINTON TINNIN RD
JACKSON MS
39209-9121
US

V. Phone/Fax

Practice location:
  • Phone: 662-614-0500
  • Fax:
Mailing address:
  • Phone: 662-614-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANEKA SIMMONS PATTERSON
Title or Position: CEO
Credential: DNP, APRN, FNP-C
Phone: 662-614-0500