Provider Demographics
NPI:1669636874
Name:BRIGHT, NANCY JEAN
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JEAN
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:PO BOX 1543
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-0167
Mailing Address - Country:US
Mailing Address - Phone:541-988-1025
Mailing Address - Fax:541-844-1051
Practice Address - Street 1:175 W B ST STE I
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4575
Practice Address - Country:US
Practice Address - Phone:541-988-1025
Practice Address - Fax:541-844-1051
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR241382Medicaid