Provider Demographics
NPI:1861908022
Name:BRIGHT, JILL (RN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 BURLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-7547
Mailing Address - Country:US
Mailing Address - Phone:831-999-3210
Mailing Address - Fax:831-265-7678
Practice Address - Street 1:2160 BURLWOOD DR
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-7547
Practice Address - Country:US
Practice Address - Phone:831-999-3210
Practice Address - Fax:831-265-7678
Is Sole Proprietor?:No
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA712805163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy