Provider Demographics
NPI:1457767188
Name:BRIGHT, SHAUNA L (FNP)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:L
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 W HIGH ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5529
Mailing Address - Country:US
Mailing Address - Phone:410-027-3243
Mailing Address - Fax:410-396-2965
Practice Address - Street 1:111 W HIGH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5529
Practice Address - Country:US
Practice Address - Phone:410-273-2439
Practice Address - Fax:410-396-2965
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0033097163W00000X, 363LF0000X
MDAC001878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse