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NPI Code Detail

MEDICARE: MRS. KELLY BETH WRIGHT APRN

MEDICARE: MRS. KELLY BETH WRIGHT APRN
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
1363LA2100XAcute Care Nurse PractitionerA004299AR

General Provider Information

NPI Number : 1720479223
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLY BETH WRIGHT APRN
Provider Business Mailing Address
First Line : PO BOX 9662
Second Line :
City : CONWAY
State : AR
Zip : 72033-9662
Country : US
Telephone Number : 501-852-1363
Fax Number : 501-852-1364
Provider Business Practice Location Address
First Line : 2200 ADA AVE STE 201
Second Line :
City : CONWAY
State : AR
Zip : 72034-4984
Country : US
Telephone Number : 501-852-1360
Fax Number : 501-552-5316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2015
Last Update Date : 04/12/2023

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