Provider Demographics
NPI:1205971678
Name:BRIGHTMAN, GERALDINE A (OGNP)
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:A
Last Name:BRIGHTMAN
Suffix:
Gender:F
Credentials:OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 W BELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053
Mailing Address - Country:US
Mailing Address - Phone:602-588-0316
Mailing Address - Fax:
Practice Address - Street 1:3033 W BELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHX
Practice Address - State:AZ
Practice Address - Zip Code:85053
Practice Address - Country:US
Practice Address - Phone:602-588-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN030280363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology