Healthcare Provider Details

I. General information

NPI: 1760825434
Provider Name (Legal Business Name): LINDA J. BRIDGES RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2013
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 RANKIN ROAD
BRANDON UNITED STATES
39042
UM

IV. Provider business mailing address

330 RANKIN RD
BRANDON MS
39042-9628
US

V. Phone/Fax

Practice location:
  • Phone: 601-941-9453
  • Fax:
Mailing address:
  • Phone: 601-941-9453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License NumberRCP1314
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: