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NPI Code Detail

MEDICARE: BRIDGECARE HEALTH NAVIGATORS, LLC

MEDICARE: BRIDGECARE HEALTH NAVIGATORS, LLC
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
1251B00000XCase Management Agency
2363L00000XNurse Practitioner

General Provider Information

NPI Number : 1407646771
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGECARE HEALTH NAVIGATORS, LLC
Provider Business Mailing Address
First Line : 6135 CLINTON TINNIN RD
Second Line :
City : JACKSON
State : MS
Zip : 39209-9121
Country : US
Telephone Number : 662-614-0500
Fax Number :
Provider Business Practice Location Address
First Line : 6135 CLINTON TINNIN RD
Second Line :
City : JACKSON
State : MS
Zip : 39209-9121
Country : US
Telephone Number : 662-614-0500
Fax Number :
Authorized Official
Title or Position : CEO
Name : MRS. SHANEKA SIMMONS PATTERSON
Credential : DNP, APRN, FNP-C
Telephone Number : 662-614-0500
Provider Enumeration Date : 05/09/2025
Last Update Date : 05/09/2025

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Directions to “BRIDGECARE HEALTH NAVIGATORS, LLC ” Practice Location

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