Healthcare Provider Details

I. General information

NPI: 1770092041
Provider Name (Legal Business Name): MR. ADAM LEE WRIGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NEUSE BLVD
NEW BERN NC
28560-3449
US

IV. Provider business mailing address

335 HILLTOP LN
WASHINGTON PA
15301-1326
US

V. Phone/Fax

Practice location:
  • Phone: 252-633-8846
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN614469
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number120608
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: