Healthcare Provider Details

I. General information

NPI: 1538409842
Provider Name (Legal Business Name): JANET KRISTINE WRIGHT CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 CREEKWAY TRL
RIDGEWAY VA
24148-4821
US

IV. Provider business mailing address

359 CREEKWAY TRL
RIDGEWAY VA
24148-4821
US

V. Phone/Fax

Practice location:
  • Phone: 276-666-5964
  • Fax:
Mailing address:
  • Phone: 276-666-5964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0230015888
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: