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NPI Code Detail

MEDICARE: MISS DOROTHY DANIELLE-MARIA WRIGHT CRNP

MEDICARE: MISS DOROTHY DANIELLE-MARIA WRIGHT CRNP
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
1363L00000XNurse Practitioner3013913KY
2363LP2300XPrimary Care Nurse Practitioner3013913KY

General Provider Information

NPI Number : 1760979413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS DOROTHY DANIELLE-MARIA WRIGHT CRNP
Provider Business Mailing Address
First Line : 222 PHILLIP STONE WAY
Second Line :
City : CENTRAL CITY
State : KY
Zip : 42330-1929
Country : US
Telephone Number : 270-754-3494
Fax Number : 270-754-3499
Provider Business Practice Location Address
First Line : 222 PHILLIP STONE WAY
Second Line :
City : CENTRAL CITY
State : KY
Zip : 42330-1929
Country : US
Telephone Number : 270-754-3494
Fax Number : 270-754-3499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2018
Last Update Date : 02/01/2024

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