Provider Demographics
NPI:1588497747
Name:BRIGHT STAR INTEGRATIVE PSYCHIATRY, LLC
Entity type:Organization
Organization Name:BRIGHT STAR INTEGRATIVE PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STIFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:717-858-2092
Mailing Address - Street 1:2 SMITH ST
Mailing Address - Street 2:P.O. BOX 4367
Mailing Address - City:JACOBUS
Mailing Address - State:PA
Mailing Address - Zip Code:17407-9800
Mailing Address - Country:US
Mailing Address - Phone:717-310-5388
Mailing Address - Fax:
Practice Address - Street 1:586 FAIRVIEW TER
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3608
Practice Address - Country:US
Practice Address - Phone:717-310-5388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty