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NPI Code Detail

MEDICARE: KAITLYN WRIGHT

MEDICARE:   KAITLYN  WRIGHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant876NE

General Provider Information

NPI Number : 1093089195
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN WRIGHT
Provider Business Mailing Address
First Line : 1204 CEDAR RIDGE CT APT 205
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-1265
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1204 CEDAR RIDGE CT APT 205
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-1265
Country : US
Telephone Number : 308-382-5440
Fax Number : 308-381-2005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2012
Last Update Date : 03/07/2012

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Directions to “ KAITLYN WRIGHT ” Practice Location

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