MEDICARE: MICHAL JHENNA 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
1	367A00000X	Advanced Practice Midwife	MW010751	PA
2	367A00000X	Advanced Practice Midwife	9496318	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215412747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAL JHENNA WRIGHT

Provider Business Mailing Address
First Line	:	850 W PLYMOUTH AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-3284
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 MEDICAL CENTER DR STE 102
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8225
Country	:	US
Telephone Number	:	386-456-3852
Fax Number	:

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

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	06/26/2024

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Directions to “ MICHAL JHENNA WRIGHT ” Practice Location

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