Provider Demographics
NPI:1417927526
Name:WRIGHT, DEAN C (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:C
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 N CENTER ST
Mailing Address - Street 2:STE 201
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5036
Mailing Address - Country:US
Mailing Address - Phone:828-327-8105
Mailing Address - Fax:828-327-4245
Practice Address - Street 1:301 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5167
Practice Address - Country:US
Practice Address - Phone:386-231-3072
Practice Address - Fax:386-231-5962
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC185664367500000X
FLAPRN11001461367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8051695Medicaid
NC2604772Medicare ID - Type Unspecified