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General NPI Number Information
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NPI Number | 1790582435
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Entity Type | Organization
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Legal Business Name | BRIGHT AND ASSOCIATES LLC
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 5727 BROOKLYN BLVD
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3057
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Country | US
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Telephone | 763-205-5880
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Fax | 763-205-5878
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Provider Business Mailing Address
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Address Line | 5727 BROOKLYN BLVD
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3057
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Country | US
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Telephone | 763-205-5880
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Fax | 763-205-5878
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Authorized Official
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Title or Position | MANAGER
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Name | MR. TOBI JAMES AGENE
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Credential |
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Telephone | 763-614-6988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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