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NPI Code Detail

MEDICARE: SHANNEN MARIE WRIGHT NURSE PRACTITIONER

MEDICARE: SHANNEN MARIE WRIGHT NURSE PRACTITIONER
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
1363LW0102XWomen's Health Nurse Practitioner657505TX

General Provider Information

NPI Number : 1538146972
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNEN MARIE WRIGHT NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 4175 S ALAMO AVE
Second Line :
City : DAVIS MONTHAN AFB
State : AZ
Zip : 85707-4402
Country : US
Telephone Number : 520-228-2665
Fax Number :
Provider Business Practice Location Address
First Line : 4175 S ALAMO AVE
Second Line :
City : DAVIS MONTHAN AFB
State : AZ
Zip : 85707-4402
Country : US
Telephone Number : 520-228-2665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 10/18/2010

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Directions to “ SHANNEN MARIE WRIGHT NURSE PRACTITIONER” Practice Location

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