MEDICARE: STEPHANIE BRIDGLAND

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1528834926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BRIDGLAND

Provider Business Mailing Address
First Line	:	299 AUTUMN RIDGE DR
Second Line	:
City	:	WENDELL
State	:	NC
Zip	:	27591-6997
Country	:	US
Telephone Number	:	919-525-8120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 OLD HENDERSON RD STE N271
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3626
Country	:	US
Telephone Number	:	614-456-7334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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Directions to “ STEPHANIE BRIDGLAND ” Practice Location

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