Provider Demographics
NPI:1285358564
Name:BRIDGES PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:BRIDGES PSYCHIATRIC SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ARNP, PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-771-7852
Mailing Address - Street 1:939 OFFICE PARK RD STE 310
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2538
Mailing Address - Country:US
Mailing Address - Phone:515-771-7852
Mailing Address - Fax:
Practice Address - Street 1:939 OFFICE PARK RD STE 310
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2538
Practice Address - Country:US
Practice Address - Phone:515-771-7852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty