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General NPI Number Information
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NPI Number | 1982092151
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Entity Type | Individual
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Provider Name | URSULA BONNER WRIGHT
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Gender | Female
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 14528 S OUTER 40 RD STE 100
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5743
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Country | US
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Telephone | 314-628-3109
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Fax |
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Provider Business Mailing Address
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Address Line | 219 EUCLID AVE
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-1613
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2014040922
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License Number State | MO
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