Provider Demographics
NPI:1821974809
Name:GONGWER, BRITTANY CHRISTINE (MSN, BSN)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:CHRISTINE
Last Name:GONGWER
Suffix:
Gender:F
Credentials:MSN, BSN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:CHRISTINE
Other - Last Name:KAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:57024 COUNTY ROAD 23
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-9559
Mailing Address - Country:US
Mailing Address - Phone:574-333-5086
Mailing Address - Fax:
Practice Address - Street 1:200 HIGH PARK AVE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-4810
Practice Address - Country:US
Practice Address - Phone:574-364-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28243078A163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency