Provider Demographics
NPI:1518394246
Name:HALENDA, BRIDGET C (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:C
Last Name:HALENDA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:BRIDGET
Other - Middle Name:CATHERINE
Other - Last Name:BOLTERSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5900 S LAKE DR
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3171
Practice Address - Country:US
Practice Address - Phone:414-489-4866
Practice Address - Fax:414-489-4015
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI195389-30163W00000X
WI5354-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100032921Medicaid