Healthcare Provider Details

I. General information

NPI: 1477180958
Provider Name (Legal Business Name): WRIGHT AND ASSOCIATES MEDICAL LOGISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 43RD AVE
GULFPORT MS
39501-2545
US

IV. Provider business mailing address

PO BOX 63
SAINT ELMO AL
36568-0063
US

V. Phone/Fax

Practice location:
  • Phone: 256-581-5708
  • Fax: 586-204-0601
Mailing address:
  • Phone: 256-581-5708
  • Fax: 586-204-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NAKIA RENEE LITTLEJOHN
Title or Position: OWNER
Credential: PMHNP-BC, FNP-BC
Phone: 256-343-3704