MEDICARE: MS. CHRISANNA G WRIGHT LMHC,RD/LD

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	133VN1006X	Metabolic Nutrition Registered Dietitian	ND2695	FL
2	101YM0800X	Mental Health Counselor	9462	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z159P	OTHER	FL	BCBSFL

General Provider Information

NPI Number	:	1871777599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISANNA G WRIGHT LMHC,RD/LD

Provider Business Mailing Address
First Line	:	PO BOX 511283
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33951-1283
Country	:	US
Telephone Number	:	941-787-3525
Fax Number	:	941-257-5550

Provider Business Practice Location Address
First Line	:	260 NW PEACOCK BLVD STE 102
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2349
Country	:	US
Telephone Number	:	941-787-3525
Fax Number	:	941-257-5550

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

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	06/26/2025

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