Healthcare Provider Details

I. General information

NPI: 1982690061
Provider Name (Legal Business Name): LINDA D WRIGHT RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N STATE ST
CLARKSDALE MS
38614-6100
US

IV. Provider business mailing address

2000 N STATE ST
CLARKSDALE MS
38614-6100
US

V. Phone/Fax

Practice location:
  • Phone: 662-627-7361
  • Fax: 662-627-1158
Mailing address:
  • Phone: 662-627-7361
  • Fax: 662-627-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR643017
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: