MEDICARE: ANGEL MARIE WRIGHT

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	172V00000X	Community Health Worker		MI
2	175T00000X	Peer Specialist		MI

General Provider Information

NPI Number	:	1730751645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL MARIE WRIGHT

Provider Business Mailing Address
First Line	:	2006 GEORGETOWN BLVD APT 1
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48911-5470
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5303 S CEDAR ST STE 202
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48911-3800
Country	:	US
Telephone Number	:	517-648-5902
Fax Number	:

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

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	03/18/2026

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Directions to “ ANGEL MARIE WRIGHT ” Practice Location

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