Healthcare Provider Details

I. General information

NPI: 1477467850
Provider Name (Legal Business Name): JENNIFER J WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4091 N GOLDENROD CT
MAIZE KS
67101-3772
US

IV. Provider business mailing address

4091 N GOLDENROD CT
MAIZE KS
67101-3772
US

V. Phone/Fax

Practice location:
  • Phone: 316-641-6368
  • Fax: 316-973-9795
Mailing address:
  • Phone: 316-641-6368
  • Fax: 316-973-9795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number92874
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: