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General NPI Number Information
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NPI Number | 1033071824
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Entity Type | Organization
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Legal Business Name | BRIGHTLIGHT SURGICAL ASSISTING, LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 4999 DREAM DANCER DR NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-0851
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Country | US
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Telephone | 505-639-3010
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Fax | 505-639-3010
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Provider Business Mailing Address
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Address Line | 4999 DREAM DANCER DR NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-0851
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Country | US
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Telephone | 505-639-3010
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Fax | 505-639-3010
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Authorized Official
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Title or Position | CERTIGIED SURGICAL FIRST ASSISTANT
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Name | ROSEMARY A GAISEY
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Credential |
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Telephone | 505-639-3010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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