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General NPI Number Information
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NPI Number | 1255850681
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Entity Type | Organization
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Legal Business Name | BRIGHTER FUTURES PEDIATRICS & LACTATION SERVICES, LLC
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 172 THOMAS JOHNSON DRIVE SUITE 200
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City | FREDERICK
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State | MD
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Zip | 21702
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Country | US
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Telephone | 301-304-9390
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Fax | 240-367-9600
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Provider Business Mailing Address
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Address Line | 172 THOMAS JOHNSON DRIVE SUITE 200
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City | FREDERICK
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State | MD
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Zip | 21702
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Country | US
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Telephone | 301-304-9390
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Fax | 240-367-9600
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CYNTHIA LEE ZELLER
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Credential | CRNP
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Telephone | 301-304-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | R108292
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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