Provider Demographics
NPI:1073954178
Name:WRIGHT, SHIRNET (CNA)
Entity Type:Individual
Prefix:
First Name:SHIRNET
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20958 111TH RD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1737
Mailing Address - Country:US
Mailing Address - Phone:917-593-9480
Mailing Address - Fax:
Practice Address - Street 1:20958 111TH RD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1737
Practice Address - Country:US
Practice Address - Phone:917-593-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342455500606E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide