Provider Demographics
NPI:1033489992
Name:WRIGHT, NICOLE ALISON
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:ALISON
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 SHADOW TREE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-9041
Mailing Address - Country:US
Mailing Address - Phone:702-417-9501
Mailing Address - Fax:
Practice Address - Street 1:3735 SHADOW TREE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-9041
Practice Address - Country:US
Practice Address - Phone:702-417-9501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner