1427165513 NPI number — MR. EDWARDS DOUGLAS BRIGHT MSN FNP

Table of content: MR. EDWARDS DOUGLAS BRIGHT MSN FNP (NPI 1427165513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427165513 NPI number — MR. EDWARDS DOUGLAS BRIGHT MSN FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRIGHT
Provider First Name:
EDWARDS
Provider Middle Name:
DOUGLAS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSN FNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427165513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1309 ROYAL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93306-6155
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-345-4987
Provider Business Mailing Address Fax Number:
888-479-3131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1021 COLUMBUS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93305-1920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-873-8004
Provider Business Practice Location Address Fax Number:
888-479-3131
Provider Enumeration Date:
08/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  NPF15733 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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