Provider Demographics
NPI:1548805633
Name:BRIDGETT, HALEY JACKSON (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:JACKSON
Last Name:BRIDGETT
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:NICHOLE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS, PA-C
Mailing Address - Street 1:3368 PENDER ST
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-1423
Mailing Address - Country:US
Mailing Address - Phone:614-542-9278
Mailing Address - Fax:
Practice Address - Street 1:HM SMITH BLVD
Practice Address - Street 2:BLDG FC-308
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547
Practice Address - Country:US
Practice Address - Phone:910-451-5125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant