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NPI Code Detail

MEDICARE: MISS SUSAN JOY WRIGHT FAMILY NURSE PRACTIT

MEDICARE: MISS SUSAN JOY WRIGHT FAMILY NURSE PRACTIT
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
1363LF0000XFamily Nurse PractitionerRN068035GA

General Provider Information

NPI Number : 1396729752
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SUSAN JOY WRIGHT FAMILY NURSE PRACTIT
Provider Business Mailing Address
First Line : 1204 ASHBOROUGH TER SE
Second Line : UNIT E
City : MARIETTA
State : GA
Zip : 30067-6935
Country : US
Telephone Number : 678-290-3312
Fax Number :
Provider Business Practice Location Address
First Line : 865 N HIGHLAND AVE NE
Second Line :
City : ATLANTA
State : GA
Zip : 30306-4565
Country : US
Telephone Number : 404-733-6089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 01/14/2009

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Directions to “ MISS SUSAN JOY WRIGHT FAMILY NURSE PRACTIT” Practice Location

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