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General NPI Number Information
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NPI Number | 1124477781
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Entity Type | Individual
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Provider Name | BRIDGETTE BAILEY SANDERS
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Gender | Female
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Dates
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Enumeration Date | 06/05/2016
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 2015 AYRSLEY TOWN BLVD STE 202
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City | CHARLOTTE
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State | NC
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Zip | 28273-4068
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Country | US
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Telephone | 704-469-7477
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Fax |
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Provider Business Mailing Address
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Address Line | 10926 QUALITY DR UNIT 38672
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City | CHARLOTTE
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State | NC
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Zip | 28278-8858
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Country | US
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Telephone | 704-718-7773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 30189
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5021590
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License Number State | NC
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