Provider Demographics
NPI:1023565074
Name:BRIGHT STAR NURSE CARE LLC
Entity Type:Organization
Organization Name:BRIGHT STAR NURSE CARE LLC
Other - Org Name:BRIGHT STAR NURSE CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:SANTIAGO
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:702-339-9077
Mailing Address - Street 1:8337 FOX BROOK ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6755
Mailing Address - Country:US
Mailing Address - Phone:702-339-9077
Mailing Address - Fax:702-453-7005
Practice Address - Street 1:8337 FOX BROOK ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-6755
Practice Address - Country:US
Practice Address - Phone:702-339-9077
Practice Address - Fax:702-453-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002076363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty