| Bright Side Wellness Llc | |
|
1279 Tammie Ter Vineland NJ 08360-5521 | |
| (856) 899-7772 | |
| (856) 249-9573 |
| Full Name | Bright Side Wellness Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1279 Tammie Ter, Vineland, New Jersey |
| Authorized Official Name and Position | Latia Pierce (OWNER) |
| Authorized Official Contact | 8568997772 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Side Wellness Llc 1279 Tammie Ter Vineland NJ 08360-5521 Ph: (856) 899-7772 | Bright Side Wellness Llc 1279 Tammie Ter Vineland NJ 08360-5521 Ph: (856) 899-7772 |
| NPI Number | 1881305415 |
|---|---|
| Provider Enumeration Date | 12/05/2022 |
| Last Update Date | 04/28/2023 |
| Medicare PECOS PAC ID | 4082086459 |
|---|---|
| Medicare Enrollment ID | O20230213000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881305415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Latia M Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740640309 PECOS PAC ID: 6406139542 Enrollment ID: I20170215000867 |
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