Jessica Marie Brightly, RDN
Individual provider Active NPI Registered Dietitian · Brockport, NY
NPI 1295595056 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1295595056
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86089385 (NY)
- Practice address
- 108 Brook Meadows TRL
Brockport, NY 14420-1247 - Phone
- (585) 281-1741
- NPI assigned
- Mar 20, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86089385 | NY | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86089385 | NY | Yes |
Addresses
Primary practice location
108 Brook Meadows TRL
Brockport, NY 14420-1247
Mailing address
108 Brook Meadows TRL
Brockport, NY 14420-1247
Phone (585) 281-1741
Other names
- Jessica Marie Page
Other providers in Brockport, NY
- Thomas E Bowdler
- Patrick Bower
- Penny Bowers
- Geena Brady
- Brian Reid Briggs
- Loretta Anne Brigman
- Brockport Central School District
- Brockport Dental PLLC
- Brockport Internal Medicine, PC
- Brockport Marriage & Family Therapy, P.C.
All providers in Brockport, NY · Registered Dietitian in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.