Provider Demographics
NPI:1538491642
Name:A BRIGHTER FUTURE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:A BRIGHTER FUTURE HEALTHCARE SERVICES
Other - Org Name:A BRIGHTER FUTURE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GANT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:910-321-6006
Mailing Address - Street 1:4140 FERNCREEK DRIVE
Mailing Address - Street 2:STE 300
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2566
Mailing Address - Country:US
Mailing Address - Phone:910-321-6006
Mailing Address - Fax:910-321-6007
Practice Address - Street 1:4140 FERNCREEK DRIVE
Practice Address - Street 2:STE 300
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2566
Practice Address - Country:US
Practice Address - Phone:910-321-6006
Practice Address - Fax:910-321-6007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A BRIGHTER FUTURE HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-01
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC150892207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000834Medicaid