Healthcare Provider Details

I. General information

NPI: 1164400453
Provider Name (Legal Business Name): MONICA ANNE WRIGHT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 ALBION ST
BRIDGEPORT CT
06605-2602
US

IV. Provider business mailing address

46 ALBION ST
BRIDGEPORT CT
06605-2602
US

V. Phone/Fax

Practice location:
  • Phone: 203-330-6000
  • Fax: 203-330-6008
Mailing address:
  • Phone: 203-330-6000
  • Fax: 203-330-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number005784
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-55503
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR864584
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: