Provider Demographics
NPI:1255728457
Name:AWOSIKA, BRIDGET K (PMHNP)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:K
Last Name:AWOSIKA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6918 ARCADIA MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2306
Mailing Address - Country:US
Mailing Address - Phone:734-718-6102
Mailing Address - Fax:810-761-7862
Practice Address - Street 1:4730 BECKNER RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4851
Practice Address - Country:US
Practice Address - Phone:505-989-4500
Practice Address - Fax:505-443-8313
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP134772363LP0808X
WAAP60884582363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health