Provider Demographics
NPI:1275837023
Name:BRIGHT, LESLIE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LESLIE
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 HERROGATE SQUARE
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8007
Mailing Address - Country:US
Mailing Address - Phone:614-962-2247
Mailing Address - Fax:
Practice Address - Street 1:619 HERROGATE SQ
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8007
Practice Address - Country:US
Practice Address - Phone:614-962-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 130765 M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse