MEDICARE: MR. MITCHELL PAUL WRIGHT JR. R.N.

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	163W00000X	Registered Nurse	RN103998	AZ

General Provider Information

NPI Number	:	1720147143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MITCHELL PAUL WRIGHT JR. R.N.

Provider Business Mailing Address
First Line	:	7263 E MINGUS TRL
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-9766
Country	:	US
Telephone Number	:	928-775-6967
Fax Number	:	928-442-8737

Provider Business Practice Location Address
First Line	:	7700 E FLORENTINE RD
Second Line	:	YAVAPAI REGIONAL MEDICAL CENTER, EAST CAMPUS
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-2245
Country	:	US
Telephone Number	:	928-442-8732
Fax Number	:	928-442-8737

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

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	07/08/2007

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