Provider Demographics
NPI:1194934810
Name:BRIGHT, RONI JEAN (NP)
Entity type:Individual
Prefix:MS
First Name:RONI
Middle Name:JEAN
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:NP
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 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5908
Mailing Address - Fax:757-446-7055
Practice Address - Street 1:855 W BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1005
Practice Address - Country:US
Practice Address - Phone:757-446-5908
Practice Address - Fax:757-446-7055
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165878363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherCORVEL/CORCARE
VA10030168NOtherSENTARA/OPTIMA HEALTH
VAPAROtherUSA MANAGED CARE
VAPAROtherMULTIPLAN
VA1194934810Medicaid
NC7004298Medicaid
VA-033OtherTRICARE/CHAMPUS
NC04298OtherBC/BS
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherVIRGINIA PREMIER HEALTH
VAMC11709Medicare PIN