Provider Demographics
NPI:1619515517
Name:BRIDGES-JONES, SHARLENE (RN)
Entity Type:Individual
Prefix:MS
First Name:SHARLENE
Middle Name:
Last Name:BRIDGES-JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7277 WOOD HOLLOW TER
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2081
Mailing Address - Country:US
Mailing Address - Phone:240-640-9394
Mailing Address - Fax:
Practice Address - Street 1:3609 SAINT BARNABAS RD STE G
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-3203
Practice Address - Country:US
Practice Address - Phone:240-640-9394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR111055163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD300178400Medicaid