MEDICARE: DEBORAH KAY WRIGHT RNP

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	363L00000X	Nurse Practitioner	P00978	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00978	OTHER	AR	RNP

General Provider Information

NPI Number	:	1558665182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH KAY WRIGHT RNP

Provider Business Mailing Address
First Line	:	14 PARKSTONE CIR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7086
Country	:	US
Telephone Number	:	501-748-3333
Fax Number	:	501-748-3456

Provider Business Practice Location Address
First Line	:	14 PARKSTONE CIR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7086
Country	:	US
Telephone Number	:	501-748-3333
Fax Number	:	501-748-3456

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

Provider Enumeration Date	:	12/21/2010
Last Update Date	:	12/21/2010

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