Provider Demographics
NPI:1245393453
Name:BRIGHT, DIANA C (MS, RD, CCN)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:C
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:MS, RD, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12910 W 24TH PL
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2221
Mailing Address - Country:US
Mailing Address - Phone:303-274-6743
Mailing Address - Fax:303-274-5004
Practice Address - Street 1:12910 W 24TH PL
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2221
Practice Address - Country:US
Practice Address - Phone:303-274-6743
Practice Address - Fax:303-274-5004
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO727467133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic