Provider Demographics
NPI:1073918538
Name:BRIGHT, JASMINE
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 W SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:KS
Mailing Address - Zip Code:67066-9575
Mailing Address - Country:US
Mailing Address - Phone:620-546-2280
Mailing Address - Fax:
Practice Address - Street 1:404 W SUMNER AVE
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:KS
Practice Address - Zip Code:67066-9575
Practice Address - Country:US
Practice Address - Phone:620-546-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician