Provider Demographics
NPI:1962218438
Name:BRIGHT, ANGELA DAWN
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
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 1:710 ROBINSON RUN
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:WV
Mailing Address - Zip Code:25286-8944
Mailing Address - Country:US
Mailing Address - Phone:304-932-6390
Mailing Address - Fax:
Practice Address - Street 1:710 ROBINSON RUN
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:WV
Practice Address - Zip Code:25286-8944
Practice Address - Country:US
Practice Address - Phone:304-932-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant