Provider Demographics
NPI:1700253994
Name:BRIGHAM, STEPHANIE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BRIGHAM
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 W CHEYENNE DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-1747
Mailing Address - Country:US
Mailing Address - Phone:602-565-5909
Mailing Address - Fax:
Practice Address - Street 1:3011 W CHEYENNE DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-1747
Practice Address - Country:US
Practice Address - Phone:602-565-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN092838163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator