MEDICARE: KAREN JEAN WRIGHT RD

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
1	133V00000X	Registered Dietitian	990819	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN32732	OTHER	NV	RN LICENSE
2	32073DI-0	OTHER	NV	REGISTERED DIETITIAN

General Provider Information

NPI Number	:	1154765220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN JEAN WRIGHT RD

Provider Business Mailing Address
First Line	:	952 VIA DEL CAMPO
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-0940
Country	:	US
Telephone Number	:	702-521-6406
Fax Number	:	702-547-4029

Provider Business Practice Location Address
First Line	:	7656 W SAHARA AVE STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2773
Country	:	US
Telephone Number	:	702-525-1105
Fax Number	:	702-666-8555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2013
Last Update Date	:	09/23/2020

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Directions to “ KAREN JEAN WRIGHT RD” Practice Location

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