Provider Demographics
NPI:1427165513
Name:BRIGHT, EDWARDS DOUGLAS (MSN FNP)
Entity type:Individual
Prefix:MR
First Name:EDWARDS
Middle Name:DOUGLAS
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:MSN FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1309 ROYAL WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-6155
Mailing Address - Country:US
Mailing Address - Phone:661-345-4987
Mailing Address - Fax:888-479-3131
Practice Address - Street 1:1021 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-1920
Practice Address - Country:US
Practice Address - Phone:661-873-8004
Practice Address - Fax:888-479-3131
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF15733363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ60917Medicare UPIN