Provider Demographics
NPI:1124365663
Name:FOSTER-WRIGHT, MICHEIKO (LPN)
Entity Type:Individual
Prefix:
First Name:MICHEIKO
Middle Name:
Last Name:FOSTER-WRIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:MICHEIKO
Other - Middle Name:
Other - Last Name:FOSTER-WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:37 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1305
Mailing Address - Country:US
Mailing Address - Phone:585-259-0410
Mailing Address - Fax:
Practice Address - Street 1:37 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1305
Practice Address - Country:US
Practice Address - Phone:585-259-0410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273733-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse