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NPI Code Detail

MEDICARE: ELISE WRIGHT

MEDICARE: ELISE 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
1363A00000XPhysician Assistant14252273-1206UT

General Provider Information

NPI Number : 1922856616
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISE WRIGHT
Provider Business Mailing Address
First Line : 3556 W 9800 S STE 101
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-3221
Country : US
Telephone Number : 801-567-9780
Fax Number :
Provider Business Practice Location Address
First Line : 1800 NOVELL PL
Second Line :
City : PROVO
State : UT
Zip : 84606-6171
Country : US
Telephone Number : 480-388-2808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2024
Last Update Date : 12/16/2025

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Directions to “ ELISE WRIGHT ” Practice Location

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