Provider Demographics
NPI:1083224463
Name:WRIGHT, NYCHOLE SHA-REESE (ADMINISTRATOR)
Entity Type:Individual
Prefix:MISS
First Name:NYCHOLE
Middle Name:SHA-REESE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26502
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19899-6502
Mailing Address - Country:US
Mailing Address - Phone:302-433-9014
Mailing Address - Fax:
Practice Address - Street 1:78 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4660
Practice Address - Country:US
Practice Address - Phone:302-525-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator