Provider Demographics
NPI:1891598363
Name:GAUDETTE, BREANNA KAYE
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:KAYE
Last Name:GAUDETTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11823 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2824
Mailing Address - Country:US
Mailing Address - Phone:360-619-8797
Mailing Address - Fax:
Practice Address - Street 1:11823 N MADISON ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2824
Practice Address - Country:US
Practice Address - Phone:360-619-8797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula