Healthcare Provider Details

I. General information

NPI: 1437325966
Provider Name (Legal Business Name): BETTY ANN WRIGHT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 W 4TH STREET RED WING HEALTH CARE CENTER
RED WING MN
55066-2180
US

IV. Provider business mailing address

1412 W 4TH STREET RED WING HEALTH CARE CENTER
RED WING MN
55066-2180
US

V. Phone/Fax

Practice location:
  • Phone: 651-388-2843
  • Fax: 651-267-0023
Mailing address:
  • Phone: 651-388-2843
  • Fax: 651-267-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number3770-026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: