MEDICARE: MICHAEL ENRIGHT PHD, APRN

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	103TC0700X	Clinical Psychologist	121	WY
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist		WY

General Provider Information

NPI Number	:	1508073834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ENRIGHT PHD, APRN

Provider Business Mailing Address
First Line	:	PO BOX 4120
Second Line	:	557 EAST BROADWAY
City	:	JACKSON
State	:	WY
Zip	:	83001-4120
Country	:	US
Telephone Number	:	307-733-7771
Fax Number	:	307-733-8276

Provider Business Practice Location Address
First Line	:	557 EAST BROADWAY STREET
Second Line	:	MEDICAL ARTS BUILDING
City	:	JACKSON
State	:	WY
Zip	:	83001-4120
Country	:	US
Telephone Number	:	307-733-7771
Fax Number	:	307-733-8276

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	09/11/2025

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