Provider Demographics
NPI:1063822088
Name:WRIGHT, LAURA KAYE (QBHP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:KAYE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:KAYE
Other - Last Name:BOLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1815 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-336-1339
Practice Address - Street 1:1101 MORGAN ST
Practice Address - Street 2:STE 8
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-3949
Practice Address - Country:US
Practice Address - Phone:870-335-9483
Practice Address - Fax:870-335-9487
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
AR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator