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NPI Code Detail

MEDICARE: BRIDGETTE BAILEY SANDERS

MEDICARE:   BRIDGETTE  BAILEY SANDERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner30189SC
2363LP0808XPsychiatric/Mental Health Nurse Practitioner5021590NC

General Provider Information

NPI Number : 1124477781
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGETTE BAILEY SANDERS
Provider Business Mailing Address
First Line : 10926 QUALITY DR UNIT 38672
Second Line :
City : CHARLOTTE
State : NC
Zip : 28278-8858
Country : US
Telephone Number : 704-718-7773
Fax Number :
Provider Business Practice Location Address
First Line : 2015 AYRSLEY TOWN BLVD STE 202
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-4068
Country : US
Telephone Number : 704-469-7477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2016
Last Update Date : 05/16/2025

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Directions to “ BRIDGETTE BAILEY SANDERS ” Practice Location

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