Provider Demographics
NPI:1427358274
Name:WRIGHT, MARYA JO (RN PMHNP)
Entity Type:Individual
Prefix:
First Name:MARYA
Middle Name:JO
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN PMHNP
Other - Prefix:
Other - First Name:MARYA
Other - Middle Name:JO
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:918 S INTERSTATE 35
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-4127
Mailing Address - Country:US
Mailing Address - Phone:512-535-3777
Mailing Address - Fax:
Practice Address - Street 1:918 S INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-4127
Practice Address - Country:US
Practice Address - Phone:512-535-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638111363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health