Provider Demographics
NPI:1326024928
Name:WRIGHT, SUSAN E (RWCNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RWCNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3780 MEDINA RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-9311
Mailing Address - Country:US
Mailing Address - Phone:330-723-6060
Mailing Address - Fax:330-723-6462
Practice Address - Street 1:3780 MEDINA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9311
Practice Address - Country:US
Practice Address - Phone:330-723-6060
Practice Address - Fax:330-723-6462
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06491363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2280044Medicaid