Healthcare Provider Details

I. General information

NPI: 1023507852
Provider Name (Legal Business Name): CHRISTOPHER HARRISON WRIGHT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ALCORN DR
CORINTH MS
38834-9388
US

IV. Provider business mailing address

2007 CHAMPION DR
CORINTH MS
38834-6031
US

V. Phone/Fax

Practice location:
  • Phone: 662-664-3731
  • Fax:
Mailing address:
  • Phone: 662-664-3731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number885346
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number24760
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901522
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: