Provider Demographics
NPI:1922739069
Name:BRIGHT, TESHA M (DOULA, RN, BSN)
Entity Type:Individual
Prefix:
First Name:TESHA
Middle Name:M
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:DOULA, RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CHINGARORA AVE
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-1067
Mailing Address - Country:US
Mailing Address - Phone:732-580-6979
Mailing Address - Fax:
Practice Address - Street 1:58 CHINGARORA AVE
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-1067
Practice Address - Country:US
Practice Address - Phone:732-580-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty