Provider Demographics
NPI:1194291526
Name:GASSAWAY, BRIDJETT RHENETTE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BRIDJETT
Middle Name:RHENETTE
Last Name:GASSAWAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:BRIDJETT
Other - Middle Name:RHENETTE
Other - Last Name:GASSAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:417 W 81ST AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5317
Mailing Address - Country:US
Mailing Address - Phone:219-237-0503
Mailing Address - Fax:877-766-1714
Practice Address - Street 1:1320 W STATE ROAD 2
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-4666
Practice Address - Country:US
Practice Address - Phone:219-727-6431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008555A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily