=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982977351
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA MARIE WRIGHT ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2012
-----------------------------------------------------
Last Update Date | 08/02/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1611 NW 12TH AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33136-1005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-585-6567
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1600 N.W. 12TH AVE.
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-585-6567
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | ARNP 9176186
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 364SF0001X
-----------------------------------------------------
Taxonomy Name | Family Health Clinical Nurse Specialist
-----------------------------------------------------
License Number | ARNP9176186
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------