Provider Demographics
NPI:1295696912
Name:BRIGHTWELL, KASSIDY DAWN (CNA)
Entity type:Individual
Prefix:
First Name:KASSIDY
Middle Name:DAWN
Last Name:BRIGHTWELL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-0364
Mailing Address - Country:US
Mailing Address - Phone:304-599-7743
Mailing Address - Fax:
Practice Address - Street 1:382 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-0364
Practice Address - Country:US
Practice Address - Phone:304-599-7743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-21
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker