Healthcare Provider Details

I. General information

NPI: 1578680997
Provider Name (Legal Business Name): JANICE A BRIGHTMAN F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3413 HARVEST DRIVE
GORDONVILLE PA
17529
US

IV. Provider business mailing address

337 W MAIN STREET
LEOLA PA
17540
US

V. Phone/Fax

Practice location:
  • Phone: 717-768-7141
  • Fax: 717-768-3528
Mailing address:
  • Phone: 717-656-6122
  • Fax: 717-656-0142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330599-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: