Provider Demographics
NPI:1275924854
Name:WRIGHT, MICHELLE CORINNE KOSCO (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:CORINNE KOSCO
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SENTARA PARK # 3
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5884
Mailing Address - Country:US
Mailing Address - Phone:757-252-3050
Mailing Address - Fax:757-222-3106
Practice Address - Street 1:1300 SENTARA PARK # 3
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5884
Practice Address - Country:US
Practice Address - Phone:757-252-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275924854Medicaid