Provider Demographics
NPI:1255848180
Name:WRIGHT, JESSIE FOORE
Entity Type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:FOORE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W COOPERATIVE WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-8209
Mailing Address - Country:US
Mailing Address - Phone:512-763-7569
Mailing Address - Fax:512-863-9178
Practice Address - Street 1:101 W COOPERATIVE WAY STE 105
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-8209
Practice Address - Country:US
Practice Address - Phone:512-763-7569
Practice Address - Fax:512-863-9178
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-31
Last Update Date:2017-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99318176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife