Provider Demographics
NPI:1134144272
Name:WRIGHT, NANCY M (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1804 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5470
Mailing Address - Country:US
Mailing Address - Phone:850-656-3361
Mailing Address - Fax:850-656-6870
Practice Address - Street 1:1804 MICCOSUKEE COMMONS DR
Practice Address - Street 2:SUITE 210
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5470
Practice Address - Country:US
Practice Address - Phone:850-656-3361
Practice Address - Fax:850-656-6870
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 722212080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000780447CMedicaid
FL251486900Medicaid
GA000780447BMedicaid