Healthcare Provider Details

I. General information

NPI: 1841253184
Provider Name (Legal Business Name): BRIDGET KANDICE GINGRAS MSN, RNC, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 01/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 GEORGE BUSH HWY
RICHARDSON TX
75082-3542
US

IV. Provider business mailing address

798 DEVERSON DR
ROCKWALL TX
75087-7172
US

V. Phone/Fax

Practice location:
  • Phone: 214-343-6663
  • Fax:
Mailing address:
  • Phone: 972-824-5339
  • Fax: 469-264-7227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number680389
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: