Provider Demographics
NPI:1528789252
Name:BRISCOE, BRIDGET (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:M
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1187 LONE OAK RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25239-8855
Mailing Address - Country:US
Mailing Address - Phone:304-377-7666
Mailing Address - Fax:
Practice Address - Street 1:606 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RAVENSWOOD
Practice Address - State:WV
Practice Address - Zip Code:26164-1730
Practice Address - Country:US
Practice Address - Phone:304-377-7666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV114E351363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health