MEDICARE: BRIGHT BEGINNINGS PEDIATRIC NURSING

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
1	251E00000X	Home Health Agency	64372	WV

General Provider Information

NPI Number	:	1184999567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT BEGINNINGS PEDIATRIC NURSING

Provider Business Mailing Address
First Line	:	57 COFER ST
Second Line	:
City	:	WASHINGTON
State	:	WV
Zip	:	26181-9502
Country	:	US
Telephone Number	:	304-861-5217
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 COFER ST
Second Line	:
City	:	WASHINGTON
State	:	WV
Zip	:	26181-9502
Country	:	US
Telephone Number	:	304-861-5217
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTY LYNN FREED
Credential	:	RN, MSN, WHNP-BC
Telephone Number	:	304-861-5217

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	03/19/2012

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