Provider Demographics
NPI:1750556205
Name:FOLEY, BRIDGET (NNP)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 LAKELAND DR STE C
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-5000
Mailing Address - Country:US
Mailing Address - Phone:601-981-5886
Mailing Address - Fax:601-981-7935
Practice Address - Street 1:1991 LAKELAND DR STE C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5000
Practice Address - Country:US
Practice Address - Phone:601-981-5886
Practice Address - Fax:601-981-7935
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR859999163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care