Healthcare Provider Details

I. General information

NPI: 1023820776
Provider Name (Legal Business Name): SIERRA WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 SE 82ND ST
RUNNELLS IA
50237-2004
US

IV. Provider business mailing address

1546 SE 82ND ST
RUNNELLS IA
50237-2004
US

V. Phone/Fax

Practice location:
  • Phone: 515-868-8038
  • Fax:
Mailing address:
  • Phone: 515-868-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: