Healthcare Provider Details

I. General information

NPI: 1659054617
Provider Name (Legal Business Name): KRISTEN WRIGHT PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 BURNS RD STE 203
PALM BEACH GARDENS FL
33410-4303
US

IV. Provider business mailing address

8974 ZEVON CT
LAKE WORTH FL
33467-5705
US

V. Phone/Fax

Practice location:
  • Phone: 561-654-9060
  • Fax:
Mailing address:
  • Phone: 561-654-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9520128
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN9520128
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9520128
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN9520128
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11037935
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: