Provider Demographics
NPI:1639114028
Name:BRIGGS, GAYLE E (ANP)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:E
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:E
Other - Last Name:VANDERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:PO BOX 6095
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-6095
Mailing Address - Country:US
Mailing Address - Phone:541-706-5922
Mailing Address - Fax:541-706-6869
Practice Address - Street 1:2500 NE NEFF RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6015
Practice Address - Country:US
Practice Address - Phone:541-388-4333
Practice Address - Fax:541-388-3446
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR092000184174400000X
OR092000184N3363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR00834439OtherMEDICARE RAILROAD
OR170941Medicaid
ORS51987Medicare UPIN
OR135752Medicare PIN