Healthcare Provider Details

I. General information

NPI: 1386470227
Provider Name (Legal Business Name): JERMESHA MOTTON WRIGHT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JERMESHA MOTTON WRIGHT APRN

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 04/19/2025
Certification Date: 04/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 LONG LOTS RD
WESTPORT CT
06880-3828
US

IV. Provider business mailing address

47 WILKINS AVE
BRIDGEPORT CT
06606-3024
US

V. Phone/Fax

Practice location:
  • Phone: 203-227-1251
  • Fax:
Mailing address:
  • Phone: 475-210-5492
  • Fax: 475-210-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14600
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: