Organization
BRIGHT HORIZION PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARJORIE MAINE CRNP (CRNP)
(347) 453-1464
Entity
Organization
Contact information
Practice address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(855) 334-1249
Mailing address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(855) 334-1249
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103220987
—
PA
Enumeration date
01/12/2023
Last updated
01/18/2023
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