Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 103492 | WV |
NPI | 1043788011 |
---|---|
Provider Name | Ms. Tiffany Morgan Bright |
First Address | Lafayette, LA 70508-3870 |
Second Address | Weirton, WV 26062-5014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2018 |
Last Update Date | 03/10/2019 |