MEDICARE: PROF. PAMELA RENEA WRIGHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	376277490297	OH
2	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1679162515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. PAMELA RENEA WRIGHT

Provider Business Mailing Address
First Line	:	513 HIGHLAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43610-1141
Country	:	US
Telephone Number	:	419-810-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	513 HIGHLAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43610-1141
Country	:	US
Telephone Number	:	419-810-1902
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	11/01/2023

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