Healthcare Provider Details

I. General information

NPI: 1144166885
Provider Name (Legal Business Name): BRIDGETTE MAXEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 FORT RD
SHERIDAN WY
82801-8320
US

IV. Provider business mailing address

1898 FORT RD
SHERIDAN WY
82801-8320
US

V. Phone/Fax

Practice location:
  • Phone: 307-672-3473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN-241783
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: