Healthcare Provider Details

I. General information

NPI: 1134144272
Provider Name (Legal Business Name): NANCY M. WRIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY WRIGHT

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 MICCOSUKEE COMMONS DR SUITE 210
TALLAHASSEE FL
32308-5470
US

IV. Provider business mailing address

1804 MICCOSUKEE COMMONS DR SUITE 210
TALLAHASSEE FL
32308-5470
US

V. Phone/Fax

Practice location:
  • Phone: 850-656-3361
  • Fax: 850-656-6870
Mailing address:
  • Phone: 850-656-3361
  • Fax: 850-656-6870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberME 72221
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: