Healthcare Provider Details

I. General information

NPI: 1043120082
Provider Name (Legal Business Name): KYARA DEVAE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17008 RIDGETON DR
CLEVELAND OH
44128-3349
US

IV. Provider business mailing address

17008 RIDGETON DR
CLEVELAND OH
44128-3349
US

V. Phone/Fax

Practice location:
  • Phone: 216-450-0895
  • Fax: 216-450-0895
Mailing address:
  • Phone: 216-450-0895
  • Fax: 216-450-0895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberVR105468
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: