Provider Demographics
NPI:1578680997
Name:BRIGHTMAN, JANICE A (FNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:A
Last Name:BRIGHTMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 W MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LEOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17540
Mailing Address - Country:US
Mailing Address - Phone:717-656-6122
Mailing Address - Fax:717-656-0142
Practice Address - Street 1:3413 HARVEST DRIVE
Practice Address - Street 2:
Practice Address - City:GORDONVILLE
Practice Address - State:PA
Practice Address - Zip Code:17529
Practice Address - Country:US
Practice Address - Phone:717-768-7141
Practice Address - Fax:717-768-3528
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330599-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50089950OtherBLUE CROSS
500009265OtherRR MEDICARE
NY000F330599Medicaid
500009265OtherRR MEDICARE