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General NPI Number Information
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NPI Number | 1073977732
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Entity Type | Individual
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Provider Name | SAMANTHA JO WRIGHT FNP
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Gender | Female
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 616 ELM ST
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City | PORTLAND
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State | TX
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Zip | 78374-1714
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Country | US
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Telephone | 361-977-2059
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Fax | 361-977-2047
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Provider Business Mailing Address
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Address Line | 5950 SARATOGA BLVD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-4100
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Country | US
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Telephone | 361-985-5811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP131228
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License Number State | TX
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