Provider Demographics
NPI:1447399043
Name:BRIGHT, BETTY LOUISE
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:LOUISE
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 1:1013 N KINGS WAY APT 218
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-1940
Mailing Address - Country:US
Mailing Address - Phone:803-865-1570
Mailing Address - Fax:
Practice Address - Street 1:2015 MARION ST
Practice Address - Street 2:ACS LAB
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2113
Practice Address - Country:US
Practice Address - Phone:803-898-0123
Practice Address - Fax:803-253-4090
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP16282164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse