Healthcare Provider Details

I. General information

NPI: 1619610581
Provider Name (Legal Business Name): HOLLY A BRIGHT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGBEE DR STE D202
BETHEL PARK PA
15102-4200
US

IV. Provider business mailing address

1000 HIGBEE DR STE D202
BETHEL PARK PA
15102-4200
US

V. Phone/Fax

Practice location:
  • Phone: 412-833-6176
  • Fax: 412-833-6421
Mailing address:
  • Phone: 412-833-6176
  • Fax: 412-833-6421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP025600
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberSP025600
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: