Healthcare Provider Details

I. General information

NPI: 1851904577
Provider Name (Legal Business Name): WHITNEY WRIGHT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2863 HIGHWAY 45 BYP
JACKSON TN
38305-3618
US

IV. Provider business mailing address

PO BOX 400
JACKSON TN
38302-0400
US

V. Phone/Fax

Practice location:
  • Phone: 731-422-0213
  • Fax: 731-660-8395
Mailing address:
  • Phone: 731-423-8697
  • Fax: 731-425-5783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28152
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: