Healthcare Provider Details

I. General information

NPI: 1720577372
Provider Name (Legal Business Name): VERNESA WRIGHT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7813 SPIVEY STATION BLVD STE 210
LAKE SPIVEY GA
30236-2900
US

IV. Provider business mailing address

1100 JOHNSON FERRY RD STE 510
SANDY SPRINGS GA
30342-1743
US

V. Phone/Fax

Practice location:
  • Phone: 770-507-0070
  • Fax: 770-507-7469
Mailing address:
  • Phone: 404-419-1165
  • Fax: 404-419-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN197993
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: