Gina Bridges, LPN
Individual provider Active NPI Licensed Practical Nurse · Shirley, NY
NPI 1003599044 · NPPES record last updated Aug 8, 2023
Key facts
- NPI
- 1003599044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 335649-01 (NY)
- Practice address
- 75 Essex Cir
Shirley, NY 11967-2565 - Phone
- (631) 205-3589
- NPI assigned
- Aug 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 335649-01 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 335649-01 | NY | |
| Licensed Practical Nurse | 164W00000X | 335649-01 | NY | Yes |
Addresses
Primary practice location
75 Essex Cir
Shirley, NY 11967-2565
Mailing address
75 Essex Cir
Shirley, NY 11967-2565
Phone (631) 205-3589
Other providers in Shirley, NY
- Taylor Boyle
- Kalsang Boztemir
- Tracey Bracco
- Jesse Brand
- Shannon Marie Brennan
- Christopher Brodie
- Stefanie Buccellato
- Diego Fernando Bustamante Jr.
- Francesca Butler
- Susan Byrne
All providers in Shirley, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.