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General NPI Number Information
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NPI Number | 1376960401
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Entity Type | Individual
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Provider Name | ELIZABETH WRIGHT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 41521 W 11MILE RD
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City | NOVI
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State | MI
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Zip | 48375
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Country | US
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Telephone | 248-299-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 7769 MANOR CIR APT 202
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City | WESTLAND
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State | MI
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Zip | 48185-6509
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Country | US
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Telephone |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703110892
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License Number State | MI
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