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General NPI Number Information
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NPI Number | 1447776570
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Entity Type | Organization
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Legal Business Name | TELEPSYCHIATRIC BRIDGE SERVICES
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4300 MARSH LANDING BLVD SUITE #203
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250
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Country | US
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Telephone | 904-686-1512
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Fax | 904-686-2354
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Provider Business Mailing Address
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Address Line | 4300 MARSH LANDING BLVD STE 203
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-1420
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Country | US
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Telephone | 904-686-1512
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Fax | 904-686-2354
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Authorized Official
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Title or Position | PMHNP-BC
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Name | MS. MARGARET ANNE PARNELL
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Credential | ARNP
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Telephone | 904-686-1512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 9336567
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License Number State | FL
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