| Bright Soul Wellness Center | |
|
2186 W Us Highway 40 Brazil IN 47834-7201 | |
| (812) 878-8223 | |
| (812) 443-0668 |
| Full Name | Bright Soul Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2186 W Us Highway 40, Brazil, Indiana |
| Authorized Official Name and Position | Maranda Mckinney (OWNER/FNP) |
| Authorized Official Contact | 8128788223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Soul Wellness Center 2186 W Us Highway 40 Brazil IN 47834-7201 Ph: (812) 878-8223 | Bright Soul Wellness Center 2186 W Us Highway 40 Brazil IN 47834-7201 Ph: (812) 878-8223 |
| NPI Number | 1598465551 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 04/09/2024 |
| Medicare PECOS PAC ID | 8426423260 |
|---|---|
| Medicare Enrollment ID | O20230410002383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598465551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Maranda R Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689127854 PECOS PAC ID: 8426339946 Enrollment ID: I20161221000974 |
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