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General NPI Number Information
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NPI Number | 1255848180
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Entity Type | Individual
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Provider Name | MRS. JESSIE FOORE WRIGHT
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Gender | Female
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Dates
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Enumeration Date | 12/31/2017
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Last Update Date | 12/31/2017
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Provider Practice Location Address
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Address Line | 101 W COOPERATIVE WAY STE 105
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City | GEORGETOWN
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State | TX
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Zip | 78626-8209
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Country | US
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Telephone | 512-763-7569
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Fax | 512-863-9178
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Provider Business Mailing Address
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Address Line | 101 W COOPERATIVE WAY STE 105
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City | GEORGETOWN
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State | TX
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Zip | 78626-8209
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Country | US
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Telephone | 512-763-7569
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Fax | 512-863-9178
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 99318
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License Number State | TX
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