Provider Demographics
NPI:1336183151
Name:BRIGHT, A LESLIE (BSN, MSN, CNP)
Entity Type:Individual
Prefix:
First Name:A
Middle Name:LESLIE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:BSN, MSN, CNP
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:LESLIE
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN, MSN , CNP
Mailing Address - Street 1:340 W COSHOCTON ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-1113
Mailing Address - Country:US
Mailing Address - Phone:740-967-5931
Mailing Address - Fax:740-967-8192
Practice Address - Street 1:340 W COSHOCTON ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031-1113
Practice Address - Country:US
Practice Address - Phone:740-967-5931
Practice Address - Fax:740-967-8192
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN178611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2679712Medicaid
OH2679712Medicaid