Organization · Type 2 NPI
Bright Star Pediatric and Adolecent Center
Pediatric Nurse Practitioner · Freeport, FL
NPI number
1629445846
Active
Practice location
75 Bay Grove Blvd
Freeport, FL 32439-1725
Mailing address
PO Box 1132
Freeport, FL 32439-1132
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 2080412 (FL) |
Pediatric Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1629445846
Bright Star Pediatric and Adolecent Center's National Provider Identifier is 1629445846, issued on Aug 24, 2015. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Freeport, FL. The record was last updated on Aug 24, 2015.