Basic Information
Provider Information
NPI: 1649598855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRIGHT
FirstName: LINDSEY
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13523 BARRETT PARKWAY DR
Address2: SUITE 210
City: BALLWIN
State: MO
PostalCode: 630213802
CountryCode: US
TelephoneNumber: 3147752816
FaxNumber: 3147752821
Practice Location
Address1: 1055 BOWLES AVE
Address2:  
City: FENTON
State: MO
PostalCode: 630262394
CountryCode: US
TelephoneNumber: 6362039700
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/12/2010
LastUpdateDate: 01/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X2005022875MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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