Basic Information
Provider Information
NPI: 1306380175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRIGHT
FirstName: BRIDGET
MiddleName: RENEE
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 S. PEORIA AVENUE
Address2:  
City: TULSA
State: OK
PostalCode: 741203820
CountryCode: US
TelephoneNumber: 9185881900
FaxNumber: 9185826405
Practice Location
Address1: 550 S. PEORIA AVENUE
Address2:  
City: TULSA
State: OK
PostalCode: 741203820
CountryCode: US
TelephoneNumber: 9185881900
FaxNumber: 9185826405
Other Information
ProviderEnumerationDate: 12/13/2016
LastUpdateDate: 12/13/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X69608OKY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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