Individual
MISS BRIDGET NICOLE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCMA,CPT, FMP
Contact information
Practice address
4903 CROSSING SPRING WAY, LOUISVILLE, KY 40229-1187
(502) 922-6653
Mailing address
6844 BARDSTOWN RD UNIT 2144, LOUISVILLE, KY 40291-3050
(502) 922-6653
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
Primary
AP-FMFX-2026-NBYHEC
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
174H00000X
Health Educator
—
KY
175F00000X
Naturopath
—
—
175L00000X
Homeopath
—
—
246Q00000X
Pathology Specialist/Technologist
—
KY
246RP1900X
Phlebotomy Technician
Primary
219767
IL
246RP1900X
Phlebotomy Technician
26-CPT353
KY
247ZC0005X
Clinical Laboratory Director (Non-physician)
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
2393
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-9767
NPCE
IL
01
—
2393
NPCE
IL
Enumeration date
07/27/2023
Last updated
06/20/2026
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