Provider Demographics
NPI:1376836106
Name:WRIGHT, TONYA WYNETTE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:WYNETTE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TONAY
Other - Middle Name:L
Other - Last Name:PELHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1018 RUCKER BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-3688
Mailing Address - Country:US
Mailing Address - Phone:334-493-3240
Mailing Address - Fax:334-493-9535
Practice Address - Street 1:511 BRANTLEY ST
Practice Address - Street 2:
Practice Address - City:OPP
Practice Address - State:AL
Practice Address - Zip Code:36467-1702
Practice Address - Country:US
Practice Address - Phone:334-493-3240
Practice Address - Fax:334-493-9535
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-097358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily