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NPI Code Detail

MEDICARE: DINA BRIGHT RN

MEDICARE: DINA BRIGHT RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse224535SC

General Provider Information

NPI Number : 1902382732
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINA BRIGHT RN
Provider Business Mailing Address
First Line : 2522 WHETSTONE LN
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-4200
Country : US
Telephone Number : 704-301-8242
Fax Number :
Provider Business Practice Location Address
First Line : 104 GEORGE BISHOP PKWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-7335
Country : US
Telephone Number : 843-901-6212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2018
Last Update Date : 07/16/2018

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