Healthcare Provider Details

I. General information

NPI: 1154075604
Provider Name (Legal Business Name): SKYLAR ELIZABETH BRIGHTBILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S EASTON RD
GLENSIDE PA
19038-3295
US

IV. Provider business mailing address

820 N MONROE ST APT C
MEDIA PA
19063-1588
US

V. Phone/Fax

Practice location:
  • Phone: 877-272-2342
  • Fax:
Mailing address:
  • Phone: 484-354-9101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: