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General NPI Number Information
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NPI Number | 1942698287
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Entity Type | Individual
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Provider Name | BETTY MANNING BRIDGES NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 1150 US HIGHWAY 41 NW STE 11&12
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City | JASPER
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State | FL
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Zip | 32052-5888
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Country | US
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Telephone | 386-792-7744
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Fax | 386-792-7745
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-778-8513
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Fax | 615-628-6877
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN153273
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9396092
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License Number State | FL
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