Healthcare Provider Details

I. General information

NPI: 1316719677
Provider Name (Legal Business Name): KIMBERLY A WRIGHT BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 JUNCTION RD
MALONE NY
12953-4224
US

IV. Provider business mailing address

324 COUNTY ROUTE 51 BLDG 1
MALONE NY
12953-4502
US

V. Phone/Fax

Practice location:
  • Phone: 518-483-6256
  • Fax: 518-483-1126
Mailing address:
  • Phone: 518-483-1251
  • Fax: 518-483-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number756069
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: