Provider Demographics
NPI:1043383722
Name:WRIGHT, PRINCESS (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:PRINCESS
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1657
Mailing Address - Country:US
Mailing Address - Phone:954-392-7157
Mailing Address - Fax:954-443-4941
Practice Address - Street 1:600 N HIATUS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5207
Practice Address - Country:US
Practice Address - Phone:954-392-7157
Practice Address - Fax:954-443-4941
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2978372363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4479Medicare PIN