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NPI Code Detail

MEDICARE: DR. BRIDGETTE NICOLE PERNIE DNP, FNP-BC

MEDICARE: DR. BRIDGETTE NICOLE PERNIE DNP, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner2025066197MI
2363LF0000XFamily Nurse Practitioner71017957AIN

General Provider Information

NPI Number : 1316819097
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIDGETTE NICOLE PERNIE DNP, FNP-BC
Provider Business Mailing Address
First Line : 1399 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-5300
Country : US
Telephone Number : 269-615-1657
Fax Number :
Provider Business Practice Location Address
First Line : 130 E CLEVELAND RD
Second Line :
City : GRANGER
State : IN
Zip : 46530-5620
Country : US
Telephone Number : 574-247-2221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2025
Last Update Date : 04/08/2026

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