Provider Demographics
NPI:1033562582
Name:BRIGHT, SARI A (CNP)
Entity Type:Individual
Prefix:MRS
First Name:SARI
Middle Name:A
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SARI
Other - Middle Name:
Other - Last Name:STROUD-LUSK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3186
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:55 ELVA CT
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1875
Practice Address - Country:US
Practice Address - Phone:937-208-7776
Practice Address - Fax:937-208-7752
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.19036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0179621Medicaid