Provider Demographics
NPI:1134511181
Name:WRIGHT, ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WISNER TRAIL
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990
Mailing Address - Country:US
Mailing Address - Phone:845-988-1131
Mailing Address - Fax:
Practice Address - Street 1:4 WISNER TRL
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-3423
Practice Address - Country:US
Practice Address - Phone:845-988-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-28
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319079-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse