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General NPI Number Information
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NPI Number | 1801080700
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Entity Type | Individual
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Provider Name | JESSIE GODWIN WRIGHT MS,RD,LD,CSR
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Gender | Female
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 3025 UNIVERSITY AVE SUITE C-1
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City | COLUMBUS
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State | GA
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Zip | 31907-2101
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Country | US
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Telephone | 706-563-5783
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Fax | 706-561-5838
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Provider Business Mailing Address
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Address Line | PO BOX 5532
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City | COLUMBUS
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State | GA
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Zip | 31906-0532
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Country | US
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Telephone | 706-563-5783
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Fax | 706-561-5838
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 95
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 514
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License Number State | AL
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