Provider Demographics
NPI:1245069590
Name:SCIBETTA, BRIDGET ELIZABETH (DNP, AGPCNP-BC)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:ELIZABETH
Last Name:SCIBETTA
Suffix:
Gender:F
Credentials:DNP, AGPCNP-BC
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:ELIZABETH
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2955 ELLEN AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1315
Mailing Address - Country:US
Mailing Address - Phone:508-524-8100
Mailing Address - Fax:
Practice Address - Street 1:6800 SW 105TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-5487
Practice Address - Country:US
Practice Address - Phone:503-430-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10029819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner