Provider Demographics
NPI:1255372637
Name:BRIGHT, CARLEE DEE (PA-C)
Entity type:Individual
Prefix:
First Name:CARLEE
Middle Name:DEE
Last Name:BRIGHT
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:CARLEE
Other - Middle Name:KEFFER
Other - Last Name:GROOMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:115 ROSEBERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-9338
Mailing Address - Country:US
Mailing Address - Phone:864-357-1566
Mailing Address - Fax:
Practice Address - Street 1:1650 SKYLYN DR STE 210
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1069
Practice Address - Country:US
Practice Address - Phone:864-671-6492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC977363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0319PAMedicaid
SC0319PAMedicaid
AA07086207Medicare PIN