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General NPI Number Information
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NPI Number | 1881433423
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Entity Type | Individual
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Provider Name | TIFFANY WRIGHT
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Gender | Female
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 124 N ENGLEWOOD DR
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2442
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Country | US
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Telephone | 919-268-0100
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Fax | 252-450-6403
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Provider Business Mailing Address
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Address Line | 3661 SUNSET AVE STE 345
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3411
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Country | US
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Telephone | 919-268-0100
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Fax | 252-450-6402
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 290996
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License Number State | NC
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