MEDICARE: STEPHANIE BRIDGES COLEY

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	163WH0200X	Home Health Registered Nurse	106-R-0028	GA

General Provider Information

NPI Number	:	1558532044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BRIDGES COLEY

Provider Business Mailing Address
First Line	:	13 ORANGE CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-2808
Country	:	US
Telephone Number	:	706-569-7697
Fax Number	:	706-569-7697

Provider Business Practice Location Address
First Line	:	13 ORANGE CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-2808
Country	:	US
Telephone Number	:	706-569-7697
Fax Number	:	706-221-9892

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

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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Directions to “ STEPHANIE BRIDGES COLEY ” Practice Location

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