Healthcare Provider Details

I. General information

NPI: 1730751645
Provider Name (Legal Business Name): ANGEL MARIE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 S CEDAR ST STE 202
LANSING MI
48911-3800
US

IV. Provider business mailing address

2006 GEORGETOWN BLVD APT 1
LANSING MI
48911-5470
US

V. Phone/Fax

Practice location:
  • Phone: 517-648-5902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: